SFEBES2021 Poster Presentations Reproductive Endocrinology (31 abstracts)
Clinical characteristics associated with testosterone prescribing in men in primary care
Aditi Sharma 1 , Zia Ul-Haq 2 , Emad Sindi 1 , Ahmed Al-Sharefi 1 , Tahereh Kamalati 2 , Waljit S. Dhillo 1 , Sukhbinder Minhas 3 & Channa N Jayasena 1
1Section of Investigative Medicine, Imperial College London, London, United Kingdom; 2Imperial College Health Partners, London, United Kingdom; 3Department of Urology, Charing Cross Hospital, Imperial Healthcare NHS Trust, London, United Kingdom
Background: Testosterone replacement therapy (TRT) is widely used for the treatment of symptomatic hypogonadism in men. However, data on prescription behaviours of TRT are limited. The objective of this study was to investigate clinical characteristics associated with the likelihood of being prescribed TRT by general practitioners (GPs) in North West London (NWL).
Methods: We carried out a retrospective cohort study using Discover database of GP-registered patients in NWL between 2015-2019. We identified 20,299 men aged 318 years who had a serum total testosterone measurement (TT) and without prior TRT prescription records, and determined whether TRT was subsequently commenced, and analysed clinical characteristics associated with hypogonadism that may influence TRT prescription.
Results: Of all men having TT measurement, 19,583 (96.4%) were not commenced on TRT (Group A) and 716 (3.5%) men were commenced on TRT (Group B). Men prescribed TRT (Group B) were older with higher mean body mass index (BMI), and higher risks of hypertension, depression, type 2 diabetes and ischaemic heart disease (IHD); conversely, men in Group B had lower mean pre-treatment TT and were less likely to have prostate cancer. Over twenty four percent of men with TT < 8nmol/l and low libido were not prescribed TRT.
Conclusions: Our study suggests that 3.5% of men in primary care with a single TT measurement had subsequent commencement of TRT. We highlight several comorbidities may influence the decisions made by GPs when initiating TRT. Clearer guidance for clinicians with unified TT cut offs may help to improve the consistency of treatment of men with hypogonadism.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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