Awareness and Indications of 5-α-Reductase Inhibitors for Benign Prostatic Hyperplasia in the Primary Care Setting

Objective The objective of the study was to investigate primary care physicians'(PCPs') level of awareness and indications for urology referral in patients treated with 5-α-reductase inhibitors (5-ARIs). Methods An anonymous 14-question survey was e-mailed to PCPs in the specialties of Family Medicine and Internal Medicine at an academic institution. Questions focused on residency graduation year, patient volume, medical practice characteristics, knowledge of 5-ARIs and their effects on prostate-specific antigen (PSA) kinetics, role of 5-ARIs in prostate cancer (PC) prevention, and indications for prostate biopsy referral. Results In total, 221 PCPs were e-mailed, 85 of whom responded (38.5% response rate). Approximately 39% of the PCPs surveyed were not aware of the suppressive effects of 5-ARIs on PSA, 63.5% were not sure or incorrectly answered when asked about calculating the corrected PSA of a patient who is taking 5-ARIs, 77.6% were not sure or would not refer for a prostate biopsy a patient who is taking 5-ARIs but has an elevated corrected PSA that needs to be calculated, 63.5% were not sure or believed that 5-ARIs may decrease the risk of high-grade PC, and 49.4% were not sure or believed that 5-ARIs are approved for the prevention of PC. There were no differences in responses between PCPs who were Family Medicine physicians and internists (P > 0.05 for all). Conclusions There is a general lack of awareness among PCPs about 5-ARIs and indications for biopsy referral in patients taking 5-ARIs. An educational opportunity exists to optimize usage of 5-ARIs and avoid delaying PC detection.