Managing LUTS in primary care: Qualitative study of GPs’ and patients’ experiences

Background: Lower urinary tract symptoms (LUTS) are common in older men and impact considerably on their quality of life. Management can be complex, and although most LUTS could be treated effectively in primary care, referrals to urology outpatients are increasing. The experiences of General Practitioners (GPs) and patients relating to the management of LUTS have not yet been fully explored. Aim: To explore GPs’ experiences of managing LUTS, together with patients’ experiences of and preferences for treatment in primary care. Design and setting: Qualitative telephone interviews with GPs and male patients presenting to primary care with bothersome LUTS. Method: Eleven GPs and 25 male patients were purposively sampled from 20 GP practices in 3 UK regions. Interviews were conducted between May 2018 and January 2019 and analysed using a framework approach. Results: Difficulty establishing causes and differentiating between prostate and bladder symptoms were key challenges to the diagnosis of LUTS in primary care, making treatment often a process of trial and error. Pharmacological treatments were commonly ineffective and often caused side-effects. Despite this, patients were generally satisfied with GP consultations and expressed a preference for treatment in primary care. Conclusion: Managing LUTS in primary care is a more accessible option for patients. Given the challenges of LUTS diagnosis, an effective diagnostic tool for use by GPs would be beneficial. Ensuring bothersome LUTS are not dismissed as a normal part of ageing is essential in improving patients’ quality of life. Greater exploration of the role of non-pharmacological treatments is needed.

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Thermal Physics and Glaucoma II: Preliminary Evidences for a Thermophysical Design of a Possible Visible-Light-Photons Therapy

Applied Sciences ◽

10.3390/app11146301 ◽

2021 ◽

Vol 11 (14) ◽

pp. 6301

Author(s):

Giulia Grisolia ◽

Mariarosa Astori ◽

Antonio Ponzetto ◽

Antonio Vercesi ◽

Umberto Lucia

Keyword(s):

Quality Of Life ◽

Thermodynamic Approach ◽

Equilibrium Thermodynamic ◽

Pharmacological Treatments ◽

Light Stimulation ◽

Cell Behaviour ◽

Thermal Physics ◽

Starting Point

Recently, a non-equilibrium thermodynamic approach has been developed in order to model the fundamental role of the membrane electric potential in the cell behaviour. A related new viewpoint is introduced, with a design of a photobiomodulation treatment in order to restore part of the visual field. Here, a first step in experimental evidence of the validity of the thermodynamic approach is developed. This result represents the starting point for future experimental improvements for light stimulation in order to improve the quality of life of the patients. The future possible therapy will be in addition to the pharmacological treatments.

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The impact of adding solifenacin to tamsulosin therapy for treatment of storage lower urinary tract symptoms owing to benign prostatic hyperplasia

African Journal of Urology ◽

10.1186/s12301-020-00094-x ◽

2020 ◽

Vol 26 (1) ◽

Author(s):

Mohamed Elbadry ◽

Ahmed Issam Ali ◽

Eman Saleh ◽

Amal Kamal ◽

Ahmed H. Gabr

Keyword(s):

Quality Of Life ◽

Lower Urinary Tract ◽

Group Versus ◽

Prostatic Hyperplasia ◽

Combination Group ◽

Urinary Tract Symptoms ◽

Bladder Symptoms ◽

Group 1 ◽

Lower Urinary

Abstract Background Benign prostatic hyperplasia (BPH) is a common problem in aging males which has a potential impact on patients’ health-related quality of life. In the present prospective study, we evaluated the effect of adding solifenacin to tamsulosin, compared to tamsulosin alone on overactive bladder symptoms scores (OABSS) and patients’ quality of life (QoL) in patients with filling lower urinary tract symptoms due to BPH. Methods Patients included in our study were randomly assigned into 2 groups: group 1 included patients with BPH who received tamsulosin alone and group 2 included patients with BPH who received a combination of tamsulosin and sofinacin. Treatment period was 12 weeks in both groups. Quality of life and overactive bladder symptoms score questionnaires were obtained and compared in both groups before and after treatment. Results No significant differences were found between both groups before treatment. At the end of treatment period, The QoL score for Group 1 patients was significantly greater than the other group (mean rank was 138.98 in tamsulosin group versus 62.02 in the combination group, P-value < 0.01). Similarly, OABSS for tamsulosin only group was significantly higher than combined treatment patients (mean rank was 145.03 in tamsulin group versus 55.98 in the combination group, P-value < 0.01). Conclusion Adding solifenacin to tamsulosin was associated with an improvement of QoL and OABSS in patients with irritative urinary symptoms due to BPH when compared with tamsulosin monotherapy.

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The role of Clinical-Functional Vulnerability Index-20 to detect quality of life in older adults assisted in primary care

Revista da Associação Médica Brasileira ◽

10.1590/1806-9282.67.01.20200387 ◽

2021 ◽

Vol 67 (1) ◽

pp. 83-87

Author(s):

Levi Bezerra Sena ◽

Larissa Paixão Batista ◽

Flávia Fonseca Fernandes ◽

Alfredo Nicodemos Cruz Santana

Keyword(s):

Quality Of Life ◽

Older Adults ◽

Primary Care ◽

Vulnerability Index

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A Refresher on Herpes Zoster, Current Status on Vaccination, and the Role of the Dermatologist

Journal of Cutaneous Medicine and Surgery ◽

10.2310/7750.2011.10033 ◽

2011 ◽

Vol 15 (4) ◽

pp. 185-191 ◽

Cited By ~ 2

Author(s):

Lyn C. Guenther ◽

Charles W. Lynde

Keyword(s):

Quality Of Life ◽

Primary Care ◽

Herpes Zoster ◽

Preventive Medicine ◽

Primary Care Physicians ◽

Current Status ◽

Age Group ◽

Increased Risk

Background: Herpes zoster (HZ) and postherpetic neuralgia (PHN) have a significant impact on quality of life. PHN is often chronic and difficult to treat. Dermatologists have always been involved in making the diagnosis of these conditions and, most recently, teaching the need for early antiviral therapy. Objective: With the introduction of a new vaccine, HZ and its difficult-to-treat complication PHN can be prevented or minimized. Preventive medicine is important and has been supported by dermatologists with sun safety programs. Patients receiving biologics are at increased risk of developing zoster. Conclusion: Dermatologists should embrace zoster vaccination and recommend routine vaccination of immunocompetent individuals > age 60 years, as well as patients of any age who are starting immunosuppressants, including biologics. Given that individuals over age 50 years are at risk for PHN and studies have shown that the vaccine's immunogenicity and safety are maintained in individuals age 50 to 59 years, vaccination in this age group may be considered. Some dermatologists may consider vaccinating their own patients, but most will likely recommend that vaccination be performed by their patients' primary care physicians.

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Quality of life in male patients with hormone-independent cancers: The role of testosterone.

Journal of Clinical Oncology ◽

10.1200/jco.2011.29.15_suppl.9125 ◽

2011 ◽

Vol 29 (15_suppl) ◽

pp. 9125-9125

Author(s):

P. Homel ◽

S. B. Fleishman ◽

M. F. Suhail ◽

V. Rosenwald

Keyword(s):

Quality Of Life ◽

Male Patients

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Re: The Role of Nocturia in the Quality of Life of Men with Lower Urinary Tract Symptoms

The Journal of Urology ◽

10.1016/j.juro.2012.04.060 ◽

2012 ◽

Vol 188 (2) ◽

pp. 512-513

Author(s):

Steven A. Kaplan

Keyword(s):

Quality Of Life ◽

Urinary Tract ◽

Lower Urinary Tract Symptoms ◽

Lower Urinary Tract ◽

Urinary Tract Symptoms ◽

Lower Urinary

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Dementia Care and the Role of Guideline Adherence in Primary Care: Cross-Sectional Findings From the DemTab Study

10.21203/rs.3.rs-546079/v1 ◽

2021 ◽

Author(s):

Sonia Lech ◽

Julie Lorraine O'Sullivan ◽

Johanna Drewelies ◽

Wolfram Herrmann ◽

Robert Spang ◽

...

Keyword(s):

Quality Of Life ◽

Primary Care ◽

Dementia Care ◽

Perceived Usefulness ◽

Trial Registration ◽

Cross Sectional ◽

People With Dementia ◽

Number Of Patients

Abstract Background: General practitioners (GPs) play a key role in the care of people with dementia (PwD). However, the role of the German Dementia Guideline in primary care remains unclear. The main objective of the present study was to examine the role of guideline-based dementia care in general practices.Methods: A cross-sectional analysis of data obtained from the DemTab study was conducted. Descriptive analyses of sociodemographic and clinical characteristics for GPs (N = 28) and PwD (N = 91) were conducted. Adherence to the German Dementia Guideline of GPs was measured at the level of PwD. Linear Mixed Models were used to analyze the associations between adherence to the German Dementia Guideline and GP factors at individual (age, years of experience as a GP, frequency of utilization of guideline, perceived usefulness of guideline) and structural (type of practice, total number of patients seen by a participating GP, and total number of PwD seen by a participating GP) levels as well as between adherence to the German Dementia Guideline and PwD’s quality of life. Results: Self-reported overall adherence of GPs was on average 71% (SD = 19.4, range: 25 – 100). Adherence to specific recommendations varied widely (from 19.2% to 95.3%) and the majority of GPs (79.1%) reported the guideline as only partially or somewhat helpful. Further, we found lower adherence to be significantly associated with higher numbers of patients (γ10 = -5.58, CI = -10.97, -0.19, p = .04). No association between adherence to the guideline and PwD’s quality of life was found (γ10 = -.86, CI = -4.18, 2.47, p = .61). Conclusion: The present study examined the role of adherence to the German Dementia Guideline recommendations in primary care. Overall, GPs reported high levels of adherence. However, major differences across guideline recommendations were found. Findings highlight the importance of guidelines for the provision of care. Dementia guidelines for GPs need to be better tailored and addressed. Further, structural changes such as more time for PwD may contribute to a sustainable change of dementia care in primary care.Trial registration: The DemTab trial was prospectively registered with the ISRCTN registry (Trial registration number: ISRCTN15854413). Registered 01 April 2019, https://doi.org/10.1186/ISRCTN15854413

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The role of Cucurbita pepo in the management of patients affected by lower urinary tract symptoms due to benign prostatic hyperplasia: A narrative review

Archivio Italiano di Urologia e Andrologia ◽

10.4081/aiua.2016.2.136 ◽

2016 ◽

Vol 88 (2) ◽

pp. 136 ◽

Cited By ~ 18

Author(s):

Rocco Damiano ◽

Tommaso Cai ◽

Paolo Fornara ◽

Corrado Antonio Franzese ◽

Rosario Leonardi ◽

...

Keyword(s):

Quality Of Life ◽

Urinary Tract ◽

Lower Urinary Tract ◽

Cucurbita Pepo ◽

Prostatic Hyperplasia ◽

Pumpkin Seed ◽

Urinary Tract Symptoms ◽

Lower Urinary

Objective: Phytotherapeutic compounds are largely used in the treatment of lower urinary tract symptoms (LUTS) related to benign prostatic hyperplasia (BPH) due to low side-effect profiles and costs, high level of acceptance by patients and a low rate of dropout. Here, we aimed to analyze all available evidence on the role of Cucurbita pepo in the treatment of LUTS-BPH. Material and methods: In May 2016 a systematic search was carried out thorough National Library of Medicine Pubmed, Scopus database and the ISI Web of Knowledge official website in order to identify all published studies on Cucurbita pepo and BPH. The following search strings were used: “Cucurbita pepo” OR “pumpkin seed” AND “prostate”; “Cucurbita pepo” AND “antiandrogen” OR “antiproliferative” OR “anti-inflammatory” OR “antioxidant activities”; “cucurbita pepo” OR “pumpkin seed” AND “LUTS” AND “symptoms improvement” OR “quality of life”. We consider for the present analysis only studies related to LUTS-BPH. Results: Among all 670 screened, 16 were related to LUTSBPH and finally analyzed. Among all, ten of them were performed in “in vitro setting” showing anti-inflammatory and antiandrogen effect, and a reduction in prostate growth and detrusor activity, while six were clinical studies. In all studies an improvement in International Prostatic Symptoms Score (IPSS) and uroflowmetry parameters has been reported. In 4 studies, an improvement in quality of life has been reported. Conclusion: On the basis of our narrative review, the use of Cucurbita pepo in the management of patients affected by LUTS-BPH seems to be useful for improving symptoms and quality of life. However, future clinical trials are requested to confirm these promising results.

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