Current Status of Benign Prostatic Hyperplasia Prescription in Korea Based on the Clinician's Urology Specialty Using Nationwide Healthcare System Data.

Purpose To analyze the prescription pattern for benign prostatic hyperplasia (BPH) based on the clinician's urology specialty. Methods We analyzed the data of patients treated with BPH from the National Health Insurance Database-Cohort (NHIDB) from 2002 to 2013. The information including the accompanying drugs, characteristics and medication treatment status of patients with BPH in Korea were analyzed; this included the type and number of medications prescribed, the ratios of prescriptions to other medications, and the underlying diseases. Results The prescription rates of alpha-blockers by non-urological clinicians were 40.5% in 2002 and 36.9% in 2013. In addition, the rates of anticholinergic and 5-alpha-reductase inhibitors prescribed by non-urological clinicians were 25% and 30%. The rates of BPH medication prescription by non-urologic experts were highest from internal medicine specialists (58.4%), and dermatology (8.3%), and general surgery (7.2%). With regards to anticholinergics, propiverine was prescribed most frequently followed by tolterodine, solifenacin succinate, fesoterodine, oxybutynin, and trospium. The proportion of prescriptions by non-urologists to urologists was 11.7% for solifenacin and 12.2% for fesoterodine. The prescription frequency of dutasteride was much lower than finasteride (56147 versus 262930), and the proportion of prescriptions by non-urologists to urologists was much lower in dutasteride (15.7%) versus finasteride (39.3%). Conclusions BPH prescriptions by non-urologists in Korea require to be verified by proper scientific values and more attention should be given to improve the quality of BPH care. Data from this study will ultimately lead to the evidence-based medication that could lead to more advanced BPH management.