ABSTRACT
Introduction:Benign prostate hyperplasia is increasingly becoming a common diagnosis among adult males in developing countries. It is reported to be causing thousands of deaths in recent years from complications, particularly among patients who proceeded to develop prostate cancer. The disease is predominantly found among males of forty years and above, with higher risk among men who predisposing factors. The diagnosis and subsequent therapy has been reported to affect the quality of life of patientsdue to anxiety, physical symptoms of the disease and impact on physical and mental health. The impact of diagnosis and therapy on quality of life vary widely between patients and socio-demographic variables. The major focus of this study is therefore to identify commonly prescribed drugs for the management of BPH, patient reported quality of life, anxiety and assess the influence of demographic factors on these outcomes.
Methods:The study was carried out at IBB specialized hospital Minna which as 105 bedtertiary hospitalowned by the Niger State government. A retrospective review of 412medical records was carried out from where information drug prescriptions, diagnostic tests and other BPH management practices were extracted (2020 – 2023). A cross sectional questionnaire based survey was carried out among patients with BPH being managed at the hospital. The survey involved the use of SF-12 survey, EPIC-CP and prostate cancer anxiety questionnaires which provided patient reported information on specific BPH symptoms (EPIC-CP), physical and mental quality of life (SF-12) and anxiety due to the disease recurrence, testing and development of prostate cancer.
Data analysis: The data was analyzed using descriptive statistics (BPH symptoms, quality of life) and inferential statistics (association between demographic factors, comorbidity and drug(s) on anxiety) using Chi squareas appropriate (SPSSversion 21 and Graph padInstat). P values <0.05 was considered statistically significant.
Results: The result showed that average age of patients was 65 years and most have been on therapy for about 4.9 years. While diagnosis and follow up monitoring was done with the use of PSA test alone, more than two thirds of patients still had PSA values greater the cut off mark of ≤ 4ng/ml. The most widely used drugs were Tamulosin (63.1%) or Tamulosin/Dutasteride (36.9%). The commonest cause of anxiety was fear of recurrence (89.7%), followed by fear of PSA tests (23.7%). There was significant association between duration of therapy to the fearof Benign prostate hyperplasia (P=0.0045), all causes of anxiety (P = <0.0001) and drugs used (P=<0.0001). Overall the greatest sources of anxiety came from fear of recurrence and PSA test which was found in a third of all patients. The most reported disease symptoms were sexual dysfunction (68.2%) and hormonal symptoms (40.3%), although younger patients (< 50 years) reported less symptoms compared to older patients. The quality of life based on BPH symptoms showed moderate scores (41 out of maximum score of 60), although the overall quality of life was good (74.9%) using SF-12 tool
Conclusion: The quality of life was good both in terms of disease specific symptoms and general health. Anxiety was largely related to fear of recurrence and PSA test although a small percentage of patients feared development of prostate cancer. Sexual dysfunction was widespread so represent an aspect of management that has not received adequate clinical intervention.
Keywords: Anxiety, Benign prostate hyperplasia, determinants, Quality of life,
