Long-Term Quality of Life in Patients with Benign Prostatic Hypertrophy: Preliminary Results of a Cohort Survey of 7,093 Patients Treated with an Alpha-1 - Adrenergic Blocker, Alfuzosin
In recent years, considerable attention has been paid to the patient’s point of view by monitoring medical care outcomes in terms of quality of life (QOL). The objective of this study was to evaluate the QOL of a representative population of patients undergoing medical treatment for symptoms of benign prostatic hypertrophy (BPH). A French BPH-specific QOL scale was constructed by a group of experts to assure content validity. A self-administered questionnaire consisting of 20 visual analogue scales exploring the physical, mental, social and general aspects of QOL was designed and validated. A total of 7,093 patients (mean age 66.7 years) was included in an open, prospective, 1-year study. The evaluation was based on symptoms and QOL questionnaires filled in by the patient at inclusion and after 3 months of treatment with alfuzosin (7.5 mg/day). 6,780 patients (96%) completed the study: 129 (1.8%) dropped out because of intolerance; 53 were or had to be operated on, and 14 had prostate carcinoma. After 3 months, the results of the symptom questionnaire confirmed the efficacy of alfuzosin on symptoms of BPH observed in previous placebo-controlled studies. The irritative symptom score improved by 57% and the obstructive score by 40%. The physical subscore of the QOL questionnaire was most improved (+44%). The mental subscore improved by 29% and the social subscore by 32%. Principal component analysis revealed 3 main components in the QOL of the population: BPH-specific interference with activities; general QOL, and sexuality, a domain which is not usually explored in studies of BPH patients. A reduced QOL score was defined to be used in future studies. These preliminary data suggest that alfuzosin could improve the QOL of BPH patients, but remain to be confirmed at the 6- and 12-month evaluations.