Lessons learnt from the variation across 6741 family/general practices in England in the use of treatments for hypogonadism.

Heald, A H, Stedman, M, Whyte, M, Livingston, M, Albanese, M, Ramachandran, Sudarshan and Hackett, G (2021) Lessons learnt from the variation across 6741 family/general practices in England in the use of treatments for hypogonadism. Clinical endocrinology. ISSN 1365-2265.

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Official URL: https://onlinelibrary.wiley.com/doi/10.1111/cen.14...

Abstract

INTRODUCTION

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.

METHODS

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 3) national GP patient survey results.

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/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=0.95, p<0.001) between PDE5-I prescribing and testosterone prescribing. Other multivariant factors independently linked with more testosterone prescribing were: 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).

CONCLUSION

Our analysis has indicated that variation between general practices in testosterone prescribing in a well developed health economy, is only related in small degree (r =0.27) to factors that we can define. This suggests that variation in amount of testosterone prescribed is largely related to general practitioner choice/other factors not studied and may be amenable to measures to increase knowledge/awareness of male hypogonadism, with implications for men's health.

Item Type: Article
Subjects: WK Endocrine system. Endocrinology
Divisions: Ambulatory Care > Endocrinology
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Depositing User: Mr Philip O'Reilly
Date Deposited: 20 Jan 2021 14:40
Last Modified: 20 Jan 2021 14:40
URI: http://www.repository.uhblibrary.co.uk/id/eprint/3868

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