Adherence to AUA guidelines for the work-up, medical management, surgical evaluation and treatment of BPH: Work from a quality improvement collaborative

IF 1.5 4区 医学 Q3 UROLOGY & NEPHROLOGY
Eric Wahlstedt, John Lee Graves, John Wahlstedt, Alison D'Alessandro, Will Cranford, Nicholas A. Freidberg, Amul Bhalodi, John R. Bell, Andrew James, Jason Bylund, Stephen E. Strup, Andrew Harris
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引用次数: 0

Abstract

Introduction

Previous studies noted varied adherence to clinical practice guidelines (CPGs), but studies are yet to quantify adherence to American Urological Association BPH guidelines. We studied guideline adherence in the context of a new quality improvement collaborative (QIC).

Methods

Data were collected as part of a statewide QIC. Medical records for patients undergoing select CPT codes from January 2020 to May 2022 were retrospectively reviewed for adherence to selected BPH guidelines.

Results

Most men were treated with transurethral resection of the prostate. Notably, 53.3% of men completed an IPSS and 52.3% had a urinalysis. 4.7% were counseled on behavioral modifications, 15.0% on medical therapy, and 100% on procedural options. For management, 79.4% were taking alpha-blockers and 59.8% were taking a 5-ARI. For evaluation, 57% had a PVR, 63.6% had prostate size measurement, 37.4% had uroflowmetry, and 12.3% were counseled about treatment failure. Postoperatively, 51.6% completed an IPSS, 57% had a PVR, 6.50% had uroflowmetry, 50.6% stopped their alpha-blocker, and 75.0% stopped their 5-ARI.

Conclusions

There was adherence to preoperative testing recommendations, but patient counseling was lacking in the initial work-up and preoperative evaluation. We will convey the data to key stakeholders, expand data collection to other institutions, and devise an improvement implementation plan.

遵守美国前列腺增生协会(AUA)关于良性前列腺增生症的检查、药物治疗、手术评估和治疗指南:质量改进合作组织的工作。
导言:以往的研究表明,临床实践指南(CPG)的遵守情况各不相同,但尚未有研究对美国泌尿协会良性前列腺增生指南的遵守情况进行量化。我们在一项新的质量改进合作项目(QIC)中对指南的遵循情况进行了研究:方法:数据收集是全州 QIC 的一部分。我们对 2020 年 1 月至 2022 年 5 月接受特定 CPT 编码治疗的患者的医疗记录进行了回顾性审查,以了解其对特定良性前列腺增生症指南的遵守情况:结果:大多数男性接受了经尿道前列腺切除术。值得注意的是,53.3%的男性完成了IPSS,52.3%的男性进行了尿检。4.7%的男性接受了行为矫正指导,15.0%的男性接受了药物治疗,100%的男性接受了手术治疗。在治疗方面,79.4% 的人服用α-受体阻滞剂,59.8% 的人服用 5-ARI 。在评估方面,57%的患者进行了PVR检查,63.6%的患者进行了前列腺大小测量,37.4%的患者进行了尿流测定,12.3%的患者接受了有关治疗失败的咨询。术后,51.6%的患者完成了IPSS检查,57%的患者进行了PVR检查,6.50%的患者进行了尿流测定,50.6%的患者停用了α-受体阻滞剂,75.0%的患者停用了5-ARI:结论:术前检查建议得到了遵守,但在初步检查和术前评估中缺乏对患者的指导。我们将向主要利益相关者传达这些数据,将数据收集工作扩展到其他机构,并制定改进实施计划。
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来源期刊
LUTS: Lower Urinary Tract Symptoms
LUTS: Lower Urinary Tract Symptoms UROLOGY & NEPHROLOGY-
CiteScore
3.00
自引率
7.70%
发文量
52
审稿时长
>12 weeks
期刊介绍: LUTS is designed for the timely communication of peer-reviewed studies which provides new clinical and basic science information to physicians and researchers in the field of neurourology, urodynamics and urogynecology. Contributions are reviewed and selected by a group of distinguished referees from around the world, some of whom constitute the journal''s Editorial Board. The journal covers both basic and clinical research on lower urinary tract dysfunctions (LUTD), such as overactive bladder (OAB), detrusor underactivity, benign prostatic hyperplasia (BPH), bladder outlet obstruction (BOO), urinary incontinence, pelvic organ prolapse (POP), painful bladder syndrome (PBS), as well as on other relevant conditions. Case reports are published only if new findings are provided. LUTS is an official journal of the Japanese Continence Society, the Korean Continence Society, and the Taiwanese Continence Society. Submission of papers from all countries are welcome. LUTS has been accepted into Science Citation Index Expanded (SCIE) with a 2011 Impact Factor.
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