Lower urinary tract symptoms suggestive of benign prostatic obstruction - Triumph: The role of general practice databases

The Triumph project aims to document the current management of lower urinar y tract symptoms (LUTS) suggestive of benign prostatic hyperplasia (BPH) in general practice and to assess the effectiveness of the initial treatment options used. The first phase of the project will consider existing data so urces in primary care. A patient's medical record will contain most, if not all, clinically relevant information, and databases combining the records from a network of computerised general practices can provide longitudinal d ata for complete populations, linking prescribing records to clinical infor mation on disease progression and outcomes for individual patients. Databas e research can provide rapid information and offers the ability to conduct studies on a scale that would previously have been prohibited by both time and expense. Within the Triumph project, the THALES, General Practice Resea rch Database (GPRD) and Integrated Primary Care Information (IPCI) database s are, or will be, used to examine the current management of LUTS/BPH in Fr ance, the UK and the Netherlands respectively. Preliminary results from the UK General Practice Research Database (GPRD) showed that LUTS/BPH incidenc e increased linearly from the ages of 45 to 85 years (r(2) = 0.992) and pre valence increased from 3.5% to 35% for men in their late 40s and 80s respec tively. With treatment failure defined as a change to another medical thera py, catheterisation or prostatic surgery, and accounting for age and year v ariation, patients receiving the older alpha (1)-blockers (indoramin and pr azosin) appeared to fail significantly earlier than those receiving finaste ride. There was no significant difference between finasteride and the newer alpha (1)-blockers (tamsulosin, alfuzosin, terazosin and doxazosin). Patte rns of changes between products from the THALES database in France were bro adly similar to those seen in the UK. Copyright (C) 2001 S. Karger AG, Base l.