1518 FACTORS INFLUENCING PATIENT DECISIONS TO INITIATE AND DISCONTINUE TESTOPEL® SUBCUTANEOUS TESTOSTERONE PELLETS FOR TREATMENT OF HYPOGONADISM

Abstract

You have accessJournal of UrologySexual Function/Dysfunction/Andrology: Medical and Nonsurgical Therapy1 Apr 20131518 FACTORS INFLUENCING PATIENT DECISIONS TO INITIATE AND DISCONTINUE TESTOPEL® SUBCUTANEOUS TESTOSTERONE PELLETS FOR TREATMENT OF HYPOGONADISM Abhinav Khanna, Saneal Rajanahally, Ryan Smith, Robert Coward, Jason Kovac, Marshall Gonzales, and Larry Lipshultz Abhinav KhannaAbhinav Khanna Houston, TX More articles by this author , Saneal RajanahallySaneal Rajanahally Houston, TX More articles by this author , Ryan SmithRyan Smith Houston, TX More articles by this author , Robert CowardRobert Coward Houston, TX More articles by this author , Jason KovacJason Kovac Houston, TX More articles by this author , Marshall GonzalesMarshall Gonzales Houston, TX More articles by this author , and Larry LipshultzLarry Lipshultz Houston, TX More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2013.02.2996AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES A variety of modalities for testosterone replacement therapy (TRT) are available, including topical gels, injections, and Testopel® subcutaneous testosterone pellets (STP). STP are becoming more commonly utilized, but patient preferences and usage patterns surrounding this therapy remain poorly characterized. We sought to identify factors influencing patients' decisions to initiate or discontinue STP and to describe their experiences with this modality. METHODS A total of 175 men from a large academic urology clinic who were currently using or had previously used STP for hypogonadism received a 32-item electronic survey. Statistical analyses were performed using chi-square and Student's t-test for categorical and continuous variables, respectively. Statistical significance was defined at p<0.05. RESULTS One-hundred-one men (response rate 57.7%), mean age 51.4 (range 25-76), completed the survey. Forty-nine (48.5%) and 40 (39.6%) men switched to STP from topical gel and injection therapy, respectively, while 12 (11.9%) men initially started TRT with STP. Convenience (80.4%) was the most important factor in patients' decision to start STP, while cost of the previous form of TRT (29.9%) was least important. Physician recommendation (81.3%) and possible transference to others (50%) were the most common reasons to switch to STP from a gel, while the gel characteristics (33.4%) were the least common. Similarly, users switching from injection therapy cited physician recommendation regarding STP (80.0%) as their primary reason for initiating STP therapy, while pain of injections (32.5%) was the least common. At the time of the survey, 31 men (31.9%) had stopped using STP. Of these, 15 (48.4%) went back to a previously used method, 8 (25.8%) switched to a previously unused method, and 8 (25.8%) stopped using TRT completely. Cost of therapy (60.0%) was the primary factor in discontinuing STP. There was no difference in serum testosterone levels between men who continued STP and those who discontinued them (704.9 vs 757.6 ng/dL, p = 0.53). CONCLUSIONS Convenience is the most important factor in a patient's decision to initiate STP; however, physician recommendation also plays a substantial role. Despite the potential disadvantages of gel and injection therapies, patients do not cite these as primary reasons for switching to STP. Cost was the primary factor in discontinuing STP. STP is a viable treatment option for hypogonadal men seeking an easy and dependable alternative modality of TRT. © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 189Issue 4SApril 2013Page: e622 Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.MetricsAuthor Information Abhinav Khanna Houston, TX More articles by this author Saneal Rajanahally Houston, TX More articles by this author Ryan Smith Houston, TX More articles by this author Robert Coward Houston, TX More articles by this author Jason Kovac Houston, TX More articles by this author Marshall Gonzales Houston, TX More articles by this author Larry Lipshultz Houston, TX More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...