Practice patterns among primary care physicians in benign prostatic hyperplasia and prostate cancer

Abstract

Background and objectives: Although patients with prostate disorders are frequently referred to urologists for diagnosis and management, primary care physicians (PCPs) are beginning to take a more active role. However, there is concern that PCPs are not optimally educated in the diagnosis and management of these disorders. This survey determined PCP practice patterns in evaluating and treating benign prostatic hyperplasia (BPH) and screening for prostate cancer.

Methods: A 10-question survey was completed by 344 physicians attending various scientific meetings in 1995.

Results: Most PCPs (89%) indicated that up to 30% of their patients have symptomatic BPH, and a significant proportion of these are treated initially by the PCP. Although 61% of PCPs are aware of the American Urological Association (AUA) symptom score and its recommended role in clinical practice guidelines, only 38% currently use it. Indications for using the AUA score include men with BPH symptoms (80%), men > 50 years (55%), and men with an abnormal digital rectal examination (DRE) (42%). The most popular BPH therapies are long-acting alpha blockers and watchful waiting. DRE is performed routinely by 84% of PCPs in men > 50 years, and annual serum prostate-specific antigen is routinely requested by 69% of PCPs.

Conclusions: Although PCPs play an increasing role in the diagnosis and management of prostate disorders, they are not taking full advantage of published clinical practice guidelines.