SHARED CARE BETWEEN GENERAL-PRACTITIONERS AND UROLOGISTS IN THE MANAGEMENT OF BENIGN PROSTATIC HYPERPLASIA - A SURVEY OF ATTITUDES AMONG CLINICIAN

Recent community-based population surveys have revealed a much greater prevalence of benign prostatic hyperplasia than previously suspected. From these data it has been projected that there may be more than 2 m illion men in the UK whose quality of life is to some extent impaired by this disorder. Since there are only 330 fully trained urologists in this country it will not be feasible for every individual presenting with prostatism to be assessed by a specialist. In an attempt to provi de a more rational basis from which family practitioners can decide wh ether or not to refer a patient for a specialist opinion a 'shared car e' flow diagram was developed and assumptions contained within field t ested by means of a postal questionnaire which was sent to 2020 urolog ists, family practitioners and other interested clinicians. There was general agreement with most of the precepts set out in the flow diagra m, the main exception was a rejection of the suggestion that every pat ient with prostatism should have a prostate-specific antigen level det ermined before referral. We conclude that there seems a consensus amon g respondents that a shared care approach to the management of BPH may both improve the standard of care provided in this area by family pra ctitioners and allow hard pressed urologists to focus greater attentio n on those patients whose conditions require surgical expertise to res olve.