Lessons learnt from the variation across 6741 family/general practices in England in the use of treatments for hypogonadism.
comorbidity
deprivation
prescribing
primary care
testosterone
Journal
Clinical endocrinology
ISSN: 1365-2265
Titre abrégé: Clin Endocrinol (Oxf)
Pays: England
ID NLM: 0346653
Informations de publication
Date de publication:
05 2021
05 2021
Historique:
revised:
14
12
2020
received:
19
07
2020
accepted:
15
12
2020
pubmed:
10
1
2021
medline:
30
9
2021
entrez:
9
1
2021
Statut:
ppublish
Résumé
We have previously reported rates of diagnosis of male hypogonadism in United Kingdom (UK) general practices. We aimed to identify factors associated with testosterone prescribing in UK general practice. We determined for 6741 general practices in England, the level of testosterone prescribing in men and the relation between volume of testosterone prescribing and (1) demographic characteristics of the practice, (2) % patients with specific comorbidities and (3) national GP patient survey results. The largest volume (by prescribing volume) agents were injectable preparations at a total cost in the 12-month period 2018/19 of £8,172,519 with gel preparations in second place: total cost £4,795,057. Transdermal patches, once the only alternative to testosterone injections or implants, were little prescribed: total cost £222,022. The analysis accounted for 0.27 of the variance in testosterone prescribing between general practices. Thus, most of this variance was not accounted for by the analysis. There was a strong univariant relation (r = .95, P < .001) between PDE5-I prescribing and testosterone prescribing. Other multivariant factors independently linked with more testosterone prescribing were as follows: HIGHER proportion of men with type 2 diabetes(T2DM) on target control (HbA1c ≤ 58 mmol/mol) and HIGHER overall practice rating on the National Patient Survey for good experience, while non-white ethnicity and socio-economic deprivation were associated with less testosterone prescribing. There were a number of comorbidity factors associated with less prescribing of testosterone (such as T2DM, hypertension and stroke/TIA). Our analysis has indicated that variation between general practices in testosterone prescribing in a well developed health economy is only related to small degree (r
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
827-836Informations de copyright
© 2021 The Authors. Clinical Endocrinology published by John Wiley & Sons Ltd.
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