Burden of benign prostatic hyperplasia among men in Japan: Patient-reported outcomes among those diagnosed and experiencing symptoms

OBJECTIVES: To quantify the burden of benign prostatic hyperplasia among Japanese men according to patient-reported outcomes. A secondary aim was to quantify the incremental burden of nocturia among these men.

METHODS: Survey data representative of the Japanese population by age and sex were analyzed (total n = 59 997). All measures were self-reported, including the revised Medical Outcomes Study 12-Item Short Form Health Survey or the revised Medical Outcomes Study 36-Item Short Form Health Survey, Work Productivity and Activity Impairment questionnaire, and 6-month healthcare use. Men aged ≥50 years were organized into three analysis groups according to diagnosis of benign prostatic hyperplasia and International Prostate Symptom Score total: diagnosed benign prostatic hyperplasia (n = 1183); undiagnosed benign prostatic hyperplasia with moderate to severe symptoms (International Prostate Symptom Score total ≥8; n = 3141); and controls (no benign prostatic hyperplasia diagnosis and International Prostate Symptom Score total <8; n = 9468). Subgroup analyses were carried out according to frequency of nocturia. Generalized linear models adjusted for potential confounders.

RESULTS: Relative to controls, diagnosed and undiagnosed benign prostatic hyperplasia respondents had reduced health-related quality of life, with mean decrements of ≥3.1 points for mental component summary scores, ≥2.0 for physical component summary scores and ≥0.05 for health utility scores (all P < 0.001). Mean absenteeism, impairment at work and non-work activity impairment among the diagnosed and undiagnosed groups were ≥1.4-fold those of the control group (P < 0.01). Both diagnosed and undiagnosed groups used significantly more healthcare than controls. The outcomes of undiagnosed men were worse than diagnosed patients on many measures. Frequent nocturia (≥3 voids per night) was associated with worse health-related quality of life.

CONCLUSIONS: Benign prostatic hyperplasia impacts health-related quality of life, work productivity and healthcare use of Japanese men, with more impact among undiagnosed men experiencing lower urinary tract symptoms and frequent nocturia.

Int J Urol. 2015 Jul 2. doi: 10.1111/iju.12849. [Epub ahead of print]

Yoshida M1, Flores NM2, Vietri J3, Lee M4, Murakami M4.

1 National Center for Geriatrics and Gerontology, Obu City, Japan.
2 Kantar Health, Los Angeles, California, USA.
3 Kantar Health, Milan, Italy.
4 Eli Lilly Japan K.K., Kobe, Japan.

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