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• W2140394567 abstract "You have accessJournal of UrologyGeneral & Epidemiological Trends & Socioeconomics: Practice Patterns, Cost Effectiveness II1 Apr 2014MP11-12 TRENDS IN TESTOSTERONE REPLACEMENT THERAPY AMONG OLDER MEN IN A REGIONAL VETERANS AFFAIRS HEALTH CARE SYSTEM Thomas Walsh, Alvin Matsumoto, Alexandra Fox, Kathryn Moore, Christopher Forsberg, Susan Heckbert, Steve Zeliadt, MaryLou Thompson, Nicholas Smith, and Molly Shores Thomas WalshThomas Walsh More articles by this author , Alvin MatsumotoAlvin Matsumoto More articles by this author , Alexandra FoxAlexandra Fox More articles by this author , Kathryn MooreKathryn Moore More articles by this author , Christopher ForsbergChristopher Forsberg More articles by this author , Susan HeckbertSusan Heckbert More articles by this author , Steve ZeliadtSteve Zeliadt More articles by this author , MaryLou ThompsonMaryLou Thompson More articles by this author , Nicholas SmithNicholas Smith More articles by this author , and Molly ShoresMolly Shores More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.427AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Low serum testosterone (T) is common, is increasingly prevalent with age, and is the only indication for T treatment. Recent studies have reported an “epidemic” of T prescribing over the last decade and there is concern about unnecessary initiation of treatment. The Veterans Affairs (VA) Health Care System provides care to a large population of older men. We investigated trends in serum T testing, the prevalence of low serum T levels among those tested, and the initiation of T treatment among those with low T. METHODS We identified all men aged 40 and older who used any VA health care in a single Veterans Integrated Service Network (VISN) in the Pacific Northwest from 2002 to 2011. For inclusion, men needed to present for care at a VA clinic on at least one occasion during the year prior to initial T testing. We excluded men with a history of prostate or breast cancer or a history of past T treatment. Low T was defined as an abnormally low value by the testing laboratory. T treatment initiation was defined as the first prescription for T. RESULTS The total number of men in the VISN increased from 129,247 in 2002 to 163,572 in 2011. During this decade, the number of men undergoing serum T testing more than doubled from 4,078 in 2002 to 9,452 in 2011; the proportion of men being tested increased by 83%, from 3.2% to 5.8% of all men. In men ages 40-49, the increase T testing was more substantial over this time period (increasing by 150% from 2.6% to 6.6% of all men) than in other decade-age groups. The observed increase in T testing occurred primarily between 2007 to 2011 (increasing by 71% in all men, and 123% in men ages 40-49). Among those tested, there was an increase over time in the proportion of men found to have low T levels: 35.0% of men tested in 2002 to 47.3% in 2011. The number of men treated with T tripled from 443 in 2002 to 1251 in 2011; however, there was no increase in the proportion of men with low T who were treated with T (31% of men with low T in 2002; 28% in 2011). Throughout the period of study, most men were treated with injectable T (81.4%), as compared to T patches (13.2%) and T gels (5.4%). CONCLUSIONS Despite secular increases in the absolute number and proportion of T testing and men with low T levels, and absolute number of men treated with T, the proportion of men with low T levels who were treated with T remained unchanged in the Pacific Northwest VA Healthcare System. The decision to treat men with T does not appear to be governed by a low serum T level alone. © 2014FiguresReferencesRelatedDetails Volume 191Issue 4SApril 2014Page: e100 Advertisement Copyright & Permissions© 2014MetricsAuthor Information Thomas Walsh More articles by this author Alvin Matsumoto More articles by this author Alexandra Fox More articles by this author Kathryn Moore More articles by this author Christopher Forsberg More articles by this author Susan Heckbert More articles by this author Steve Zeliadt More articles by this author MaryLou Thompson More articles by this author Nicholas Smith More articles by this author Molly Shores More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ..." @default.
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• W2140394567 title "MP11-12 TRENDS IN TESTOSTERONE REPLACEMENT THERAPY AMONG OLDER MEN IN A REGIONAL VETERANS AFFAIRS HEALTH CARE SYSTEM" @default.
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