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• W2046196232 abstract "No AccessJournal of UrologyAdult Urology: Voiding Dysfunction1 Dec 2004ELICITING PREFERENCES FOR DRUG TREATMENT OF LOWER URINARY TRACT SYMPTOMS ASSOCIATED WITH BENIGN PROSTATIC HYPERPLASIA V. WATSON, M. RYAN, C.T. BROWN, G. BARNETT, B.W. ELLIS, and M. EMBERTON V. WATSONV. WATSON More articles by this author , M. RYANM. RYAN More articles by this author , C.T. BROWNC.T. BROWN More articles by this author , G. BARNETTG. BARNETT Financial interest and/or other relationship with GlaxoSmithKline More articles by this author , B.W. ELLISB.W. ELLIS More articles by this author , and M. EMBERTONM. EMBERTON Financial interest and/or other relationship with GlaxoSmithKline More articles by this author View All Author Informationhttps://doi.org/10.1097/01.ju.0000140957.31325.7fAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: There are 2 main medical preparations available for lower urinary tract symptoms resulting from benign prostatic hyperplasia (BPH). Choosing between an α-blocker and a 5α-reductase inhibitor requires trade-offs between their attributes or characteristics. We investigated the relative importance of and trade-offs between the attributes of the 5α-reductase inhibitor dutasteride and α-blockers in community dwelling men using a validated technique. Materials and Methods: A discrete choice experiment was administered to 211 men older than 40 years who were randomly selected from the general United Kingdom population. Attributes investigated in the discrete choice experiment were time to symptom improvement, sexual and nonsexual side effects, the risks of acute urinary retention (AUR) and surgery, cost and prostate size decrease. Using regression analysis the relative importance of these attributes, the trade-offs that men are willing to make between these attributes and the willingness to pay for each attribute were estimated. Results: All attributes were important to respondents. The most important attribute was side effects. The least preferred side effects was impotence, followed by decreased libido and dizziness. Respondents were willing to wait 13, 2 and 8 months longer for symptom improvement in exchange for decreased prostate size, and the risks of AUR and surgery, respectively. Men reporting moderate symptoms were less concerned about sexual side effects, time to symptom improvement and the risk of AUR compared with men reporting mild symptoms. Conclusions: Given the attribute levels of BPH medical treatment, overall community dwelling men preferred the 5α-reductase inhibitor over α-blockers. In the interests of shared decision making it is important to consider the importance of eliciting the preferences of patients with BPH. References 1 : High prevalence of benign prostatic hypertrophy in the community. Lancet1991; 338: 469. Google Scholar 2 : The management of men with acute urinary retention. National Prostatectomy Audit Steering Group. Br J Urol1998; 81: 712. Google Scholar 3 : Benign prostatic hyperplasia: a progressive disease of aging men. Urology2003; 61: 267. Google Scholar 4 : Treatment choice for benign prostatic hyperplasia: a matter of urologist preference?. J Urol1999; 161: 133. Link, Google Scholar 5 de la Rosette, J., Alivizatos, G., Madersbacher, S., Rioja Sanz, C., Nordling, J. and Emberton, M.: European Urological Association Guidelines on BPH, 2002. Available at http://www.uroweb.nl/files/uploadedfiles/guidelines/updateBPH.pdf. Accessed September 14, 2004 Google Scholar 6 : Patient reactions to a program designed to facilitate patient participation in treatment decisions for benign prostatic hyperplasia. Med Care1995; 33: 771. Google Scholar 7 : Using conjoint analysis to elicit preferences for health care. BMJ2000; 320: 1530. Google Scholar 8 : Phase III multicentre placebo-controlled study of tamsulosin in benign prostatic hyperplasia. Tamsulosin Investigator Group. Urology1998; 51: 892. Google Scholar 9 : Doxazosin in the treatment of benign prostatic hyperplasia in normotensive patients: a multicenter study. J Urol1995; 154: 105. Link, Google Scholar 10 : Efficacy and safety of a dual inhibitor of 5-alpha-reductase types 1 and 2 (dutasteride) in men with benign prostatic hyperplasia. Urology2002; 60: 434. Google Scholar 11 : Stated Choice Methods: Analysis and Application. Cambridge, United Kingdom: Cambridge University Press2000. Google Scholar 12 : Using discrete choice experiments to value health care programmes: current practice and future research reflections. Appl Health Econ Health Policy2003; 2: 55. Google Scholar 13 : Willingness-to-pay as a measure of benefits. Relevant questions in the context of public decisionmaking about health care programs. Med Care1991; 29: 1246. Google Scholar From the Health Economics Research Unit, University of Aberdeen (VW, MR), Aberdeen, Clinical Effectiveness Unit, Royal College of Surgeons (CTB, ME) and Institute of Urology (CTB, ME), London, GlaxoSmithKline Research and Development (GB), Brentford and Department of Urology, Ashford St Peter's Hospital (BWE), Middlesex, United Kingdom© 2004 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited byRoehrborn C, Wilson T and Black L (2018) Quantifying the Contribution of Symptom Improvement to Satisfaction of Men With Moderate to Severe Benign Prostatic Hyperplasia: 4-Year Data From the CombAT TrialJournal of Urology, VOL. 187, NO. 5, (1732-1738), Online publication date: 1-May-2012. Volume 172Issue 6 Part 1December 2004Page: 2321-2325 Advertisement Copyright & Permissions© 2004 by American Urological Association, Inc.KeywordsGG 745urinary tractprostatic hyperplasiaprostateadrenergic α-antagonistsMetricsAuthor Information V. WATSON More articles by this author M. RYAN More articles by this author C.T. BROWN More articles by this author G. BARNETT Financial interest and/or other relationship with GlaxoSmithKline More articles by this author B.W. ELLIS More articles by this author M. EMBERTON Financial interest and/or other relationship with GlaxoSmithKline More articles by this author Expand All Advertisement PDF downloadLoading ..." @default.
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• W2046196232 title "ELICITING PREFERENCES FOR DRUG TREATMENT OF LOWER URINARY TRACT SYMPTOMS ASSOCIATED WITH BENIGN PROSTATIC HYPERPLASIA" @default.
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