Real-world adherence and persistence with medication among men with lower urinary tract symptoms owing to benign prostatic hyperplasia in Japan: a clinical prospective study

Purpose We investigated the persistence of medication for lower urinary tract symptoms/benign prostatic hyperplasia (LUTS/BPH) and identified baseline factors associated with treatment discontinuation in a clinical cohort of Japanese men. Methods We included 2500 patients between April 1, 2014 and March 31, 2015. The final analysis included 2295 patients from 30 urological hospitals. We collected baseline characteristics, including age, prostate-specific antigen (PSA) level, prostate volume (PV), International Prostate Symptom Score (IPSS), and quality-of-life (QOL) score. The type of initial medication and reasons for treatment discontinuation were recorded. Results The median participant age was 72 years. The median PSA level was 2.4 ng/mL, the median PV was 33 mL, the median IPSS score was 15 points, and the median QOL score was 5 points. The median time to medication discontinuation was 154 days (95% confidence interval [CI]: 132–176). Persistence rates at 1, 2, 3, 4, and 5 years were 37.3%, 29.1%, 24.2%, 20.2%, and 17.8%, respectively. The most common reason for discontinuation was loss to follow-up (71.1%). Multivariate analysis showed that younger age (70–79 vs. ≥80 years and ≤ 69 vs. ≥80 years), higher PSA level (≥ 2.4 ng/mL vs. <2.4 ng/mL, greater PV (≥ 33 mL vs. <33 mL), and month of medication initiation were significantly associated with longer treatment persistence. Conclusion Persistence of treatment with medication for LUTS/BPH was relatively low in our cohort. Several baseline factors, including age, PSA level, PV, and the month of treatment initiation, were identified as predictors of treatment persistence.