Awareness and Indications of 5-α-Reductase Inhibitors for Benign Prostatic Hyperplasia in the Primary Care Setting.

Objective: The objective of the study was to investigate primary care physicians' (PCPs') level of awareness and indications for urology referral in patients treated with 5-α-reductase inhibitors (5-ARIs).

Methods: An anonymous 14-question survey was e-mailed to PCPs in the specialties of Family Medicine and Internal Medicine at an academic institution. Questions focused on residency graduation year, patient volume, medical practice characteristics, knowledge of 5-ARIs and their effects on prostate-specific antigen (PSA) kinetics, role of 5-ARIs in prostate cancer (PC) prevention, and indications for prostate biopsy referral.

Results: In total, 221 PCPs were e-mailed, 85 of whom responded (38.5% response rate). Approximately 39% of the PCPs surveyed were not aware of the suppressive effects of 5-ARIs on PSA, 63.5% were not sure or incorrectly answered when asked about calculating the corrected PSA of a patient who is taking 5-ARIs, 77.6% were not sure or would not refer for a prostate biopsy a patient who is taking 5-ARIs but has an elevated corrected PSA that needs to be calculated, 63.5% were not sure or believed that 5-ARIs may decrease the risk of high-grade PC, and 49.4% were not sure or believed that 5-ARIs are approved for the prevention of PC. There were no differences in responses between PCPs who were Family Medicine physicians and internists (P > 0.05 for all).

Conclusions: There is a general lack of awareness among PCPs about 5-ARIs and indications for biopsy referral in patients taking 5-ARIs. An educational opportunity exists to optimize usage of 5-ARIs and avoid delaying PC detection.