Patterns of prescription and adherence to European Association of Urology guidelines on androgen deprivation therapy in prostate cancer: An Italian multicentre cross-sectional analysis from the Choosing Treatment for Prostate Cancer (CHOICE) study

Giuseppe Morgia, Giorgio Ivan Russo, Andrea Tubaro, Roberto Bortolus, Donato Randone, Pietro Gabriele, Fabio Trippa, Filiberto Zattoni, Massimo Porena, Vincenzo Mirone, Sergio Serni, Alberto Del Nero, Giancarlo Lay, Umberto Ricardi, Francesco Rocco, Carlo Terrone, Arcangelo Pagliarulo, Giuseppe Ludovico, Giuseppe Vespasiani, Maurizio BrausiClaudio Simeone, Giovanni Novella, Giorgio Carmignani, Rosario Leonardi, Paola Pinnarò, Ugo De Paula, Renzo Corvò, Raffaele Tenaglia, Salvatore Siracusano, Giovanna Mantini, Paolo Gontero, Gianfranco Savoca, Vincenzo Ficarra

Research output: Contribution to journalArticle

Abstract

Objective: To evaluate both the patterns of prescription of androgen deprivation therapy (ADT) in patients with prostate cancer (PCa) and the adherence to European Association of Urology (EAU) guidelines for ADT prescription. Methods: The Choosing Treatment for Prostate Cancer (CHOICE) study was an Italian multicentre cross-sectional study conducted between December 2010 and January 2012. A total of 1 386 patients, treated with ADT for PCa (first prescription or renewal of ADT), were selected. With regard to the EAU guidelines on ADT, the cohort was categorized into discordant ADT (Group A) and concordant ADT (Group B). Results: The final cohort included 1 075 patients with a geographical distribution including North Italy (n = 627, 58.3%), Central Italy (n = 233, 21.7%) and South Italy (n = 215, 20.0%). In the category of patients treated with primary ADT, a total of 125 patients (56.3%) were classified as low risk according to D'Amico classification. With regard to the EAU guidelines, 285 (26.51%) and 790 patients (73.49%) were classified as discordant (Group A) and concordant (Group B), respectively. In Group A, patients were more likely to receive primary ADT (57.5%, 164/285 patients) than radical prostatectomy (RP; 30.9%, 88/285 patients), radiation therapy (RT; 6.7%, 19/285 patients) or RP + RT (17.7%, 14/285 patients; P <0.01). Multivariate logistic regression analysis, adjusted for clinical and pathological variables, showed that patients from Central Italy (odds ratio [OR] 2.86; P <0.05) and South Italy (OR 2.65; P <0.05) were more likely to receive discordant ADT. Conclusion: EAU guideline adherence for ADT was low in Italy and was influenced by geographic area. Healthcare providers and urologists should consider these results in order to quantify the inadequate use of ADT and to set policy strategies to overcome this risk.

Original languageEnglish
JournalBJU International
DOIs
Publication statusAccepted/In press - 2016

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Guideline Adherence
Androgens
Prescriptions
Prostatic Neoplasms
Cross-Sectional Studies
Italy
Urology
Therapeutics
Group Psychotherapy
Odds Ratio
Guidelines
Prostatectomy
Health Personnel

Keywords

  • Adherence
  • Androgen deprivation therapy
  • European Association of Urology
  • Guidelines
  • Prostate cancer

ASJC Scopus subject areas

  • Urology

Cite this

Patterns of prescription and adherence to European Association of Urology guidelines on androgen deprivation therapy in prostate cancer : An Italian multicentre cross-sectional analysis from the Choosing Treatment for Prostate Cancer (CHOICE) study. / Morgia, Giuseppe; Russo, Giorgio Ivan; Tubaro, Andrea; Bortolus, Roberto; Randone, Donato; Gabriele, Pietro; Trippa, Fabio; Zattoni, Filiberto; Porena, Massimo; Mirone, Vincenzo; Serni, Sergio; Del Nero, Alberto; Lay, Giancarlo; Ricardi, Umberto; Rocco, Francesco; Terrone, Carlo; Pagliarulo, Arcangelo; Ludovico, Giuseppe; Vespasiani, Giuseppe; Brausi, Maurizio; Simeone, Claudio; Novella, Giovanni; Carmignani, Giorgio; Leonardi, Rosario; Pinnarò, Paola; De Paula, Ugo; Corvò, Renzo; Tenaglia, Raffaele; Siracusano, Salvatore; Mantini, Giovanna; Gontero, Paolo; Savoca, Gianfranco; Ficarra, Vincenzo.

In: BJU International, 2016.

Research output: Contribution to journalArticle

Morgia, G, Russo, GI, Tubaro, A, Bortolus, R, Randone, D, Gabriele, P, Trippa, F, Zattoni, F, Porena, M, Mirone, V, Serni, S, Del Nero, A, Lay, G, Ricardi, U, Rocco, F, Terrone, C, Pagliarulo, A, Ludovico, G, Vespasiani, G, Brausi, M, Simeone, C, Novella, G, Carmignani, G, Leonardi, R, Pinnarò, P, De Paula, U, Corvò, R, Tenaglia, R, Siracusano, S, Mantini, G, Gontero, P, Savoca, G & Ficarra, V 2016, 'Patterns of prescription and adherence to European Association of Urology guidelines on androgen deprivation therapy in prostate cancer: An Italian multicentre cross-sectional analysis from the Choosing Treatment for Prostate Cancer (CHOICE) study', BJU International. https://doi.org/10.1111/bju.13307
Morgia, Giuseppe ; Russo, Giorgio Ivan ; Tubaro, Andrea ; Bortolus, Roberto ; Randone, Donato ; Gabriele, Pietro ; Trippa, Fabio ; Zattoni, Filiberto ; Porena, Massimo ; Mirone, Vincenzo ; Serni, Sergio ; Del Nero, Alberto ; Lay, Giancarlo ; Ricardi, Umberto ; Rocco, Francesco ; Terrone, Carlo ; Pagliarulo, Arcangelo ; Ludovico, Giuseppe ; Vespasiani, Giuseppe ; Brausi, Maurizio ; Simeone, Claudio ; Novella, Giovanni ; Carmignani, Giorgio ; Leonardi, Rosario ; Pinnarò, Paola ; De Paula, Ugo ; Corvò, Renzo ; Tenaglia, Raffaele ; Siracusano, Salvatore ; Mantini, Giovanna ; Gontero, Paolo ; Savoca, Gianfranco ; Ficarra, Vincenzo. / Patterns of prescription and adherence to European Association of Urology guidelines on androgen deprivation therapy in prostate cancer : An Italian multicentre cross-sectional analysis from the Choosing Treatment for Prostate Cancer (CHOICE) study. In: BJU International. 2016.
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title = "Patterns of prescription and adherence to European Association of Urology guidelines on androgen deprivation therapy in prostate cancer: An Italian multicentre cross-sectional analysis from the Choosing Treatment for Prostate Cancer (CHOICE) study",
abstract = "Objective: To evaluate both the patterns of prescription of androgen deprivation therapy (ADT) in patients with prostate cancer (PCa) and the adherence to European Association of Urology (EAU) guidelines for ADT prescription. Methods: The Choosing Treatment for Prostate Cancer (CHOICE) study was an Italian multicentre cross-sectional study conducted between December 2010 and January 2012. A total of 1 386 patients, treated with ADT for PCa (first prescription or renewal of ADT), were selected. With regard to the EAU guidelines on ADT, the cohort was categorized into discordant ADT (Group A) and concordant ADT (Group B). Results: The final cohort included 1 075 patients with a geographical distribution including North Italy (n = 627, 58.3{\%}), Central Italy (n = 233, 21.7{\%}) and South Italy (n = 215, 20.0{\%}). In the category of patients treated with primary ADT, a total of 125 patients (56.3{\%}) were classified as low risk according to D'Amico classification. With regard to the EAU guidelines, 285 (26.51{\%}) and 790 patients (73.49{\%}) were classified as discordant (Group A) and concordant (Group B), respectively. In Group A, patients were more likely to receive primary ADT (57.5{\%}, 164/285 patients) than radical prostatectomy (RP; 30.9{\%}, 88/285 patients), radiation therapy (RT; 6.7{\%}, 19/285 patients) or RP + RT (17.7{\%}, 14/285 patients; P <0.01). Multivariate logistic regression analysis, adjusted for clinical and pathological variables, showed that patients from Central Italy (odds ratio [OR] 2.86; P <0.05) and South Italy (OR 2.65; P <0.05) were more likely to receive discordant ADT. Conclusion: EAU guideline adherence for ADT was low in Italy and was influenced by geographic area. Healthcare providers and urologists should consider these results in order to quantify the inadequate use of ADT and to set policy strategies to overcome this risk.",
keywords = "Adherence, Androgen deprivation therapy, European Association of Urology, Guidelines, Prostate cancer",
author = "Giuseppe Morgia and Russo, {Giorgio Ivan} and Andrea Tubaro and Roberto Bortolus and Donato Randone and Pietro Gabriele and Fabio Trippa and Filiberto Zattoni and Massimo Porena and Vincenzo Mirone and Sergio Serni and {Del Nero}, Alberto and Giancarlo Lay and Umberto Ricardi and Francesco Rocco and Carlo Terrone and Arcangelo Pagliarulo and Giuseppe Ludovico and Giuseppe Vespasiani and Maurizio Brausi and Claudio Simeone and Giovanni Novella and Giorgio Carmignani and Rosario Leonardi and Paola Pinnar{\`o} and {De Paula}, Ugo and Renzo Corv{\`o} and Raffaele Tenaglia and Salvatore Siracusano and Giovanna Mantini and Paolo Gontero and Gianfranco Savoca and Vincenzo Ficarra",
year = "2016",
doi = "10.1111/bju.13307",
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journal = "BJU International",
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}

TY - JOUR

T1 - Patterns of prescription and adherence to European Association of Urology guidelines on androgen deprivation therapy in prostate cancer

T2 - An Italian multicentre cross-sectional analysis from the Choosing Treatment for Prostate Cancer (CHOICE) study

AU - Morgia, Giuseppe

AU - Russo, Giorgio Ivan

AU - Tubaro, Andrea

AU - Bortolus, Roberto

AU - Randone, Donato

AU - Gabriele, Pietro

AU - Trippa, Fabio

AU - Zattoni, Filiberto

AU - Porena, Massimo

AU - Mirone, Vincenzo

AU - Serni, Sergio

AU - Del Nero, Alberto

AU - Lay, Giancarlo

AU - Ricardi, Umberto

AU - Rocco, Francesco

AU - Terrone, Carlo

AU - Pagliarulo, Arcangelo

AU - Ludovico, Giuseppe

AU - Vespasiani, Giuseppe

AU - Brausi, Maurizio

AU - Simeone, Claudio

AU - Novella, Giovanni

AU - Carmignani, Giorgio

AU - Leonardi, Rosario

AU - Pinnarò, Paola

AU - De Paula, Ugo

AU - Corvò, Renzo

AU - Tenaglia, Raffaele

AU - Siracusano, Salvatore

AU - Mantini, Giovanna

AU - Gontero, Paolo

AU - Savoca, Gianfranco

AU - Ficarra, Vincenzo

PY - 2016

Y1 - 2016

N2 - Objective: To evaluate both the patterns of prescription of androgen deprivation therapy (ADT) in patients with prostate cancer (PCa) and the adherence to European Association of Urology (EAU) guidelines for ADT prescription. Methods: The Choosing Treatment for Prostate Cancer (CHOICE) study was an Italian multicentre cross-sectional study conducted between December 2010 and January 2012. A total of 1 386 patients, treated with ADT for PCa (first prescription or renewal of ADT), were selected. With regard to the EAU guidelines on ADT, the cohort was categorized into discordant ADT (Group A) and concordant ADT (Group B). Results: The final cohort included 1 075 patients with a geographical distribution including North Italy (n = 627, 58.3%), Central Italy (n = 233, 21.7%) and South Italy (n = 215, 20.0%). In the category of patients treated with primary ADT, a total of 125 patients (56.3%) were classified as low risk according to D'Amico classification. With regard to the EAU guidelines, 285 (26.51%) and 790 patients (73.49%) were classified as discordant (Group A) and concordant (Group B), respectively. In Group A, patients were more likely to receive primary ADT (57.5%, 164/285 patients) than radical prostatectomy (RP; 30.9%, 88/285 patients), radiation therapy (RT; 6.7%, 19/285 patients) or RP + RT (17.7%, 14/285 patients; P <0.01). Multivariate logistic regression analysis, adjusted for clinical and pathological variables, showed that patients from Central Italy (odds ratio [OR] 2.86; P <0.05) and South Italy (OR 2.65; P <0.05) were more likely to receive discordant ADT. Conclusion: EAU guideline adherence for ADT was low in Italy and was influenced by geographic area. Healthcare providers and urologists should consider these results in order to quantify the inadequate use of ADT and to set policy strategies to overcome this risk.

AB - Objective: To evaluate both the patterns of prescription of androgen deprivation therapy (ADT) in patients with prostate cancer (PCa) and the adherence to European Association of Urology (EAU) guidelines for ADT prescription. Methods: The Choosing Treatment for Prostate Cancer (CHOICE) study was an Italian multicentre cross-sectional study conducted between December 2010 and January 2012. A total of 1 386 patients, treated with ADT for PCa (first prescription or renewal of ADT), were selected. With regard to the EAU guidelines on ADT, the cohort was categorized into discordant ADT (Group A) and concordant ADT (Group B). Results: The final cohort included 1 075 patients with a geographical distribution including North Italy (n = 627, 58.3%), Central Italy (n = 233, 21.7%) and South Italy (n = 215, 20.0%). In the category of patients treated with primary ADT, a total of 125 patients (56.3%) were classified as low risk according to D'Amico classification. With regard to the EAU guidelines, 285 (26.51%) and 790 patients (73.49%) were classified as discordant (Group A) and concordant (Group B), respectively. In Group A, patients were more likely to receive primary ADT (57.5%, 164/285 patients) than radical prostatectomy (RP; 30.9%, 88/285 patients), radiation therapy (RT; 6.7%, 19/285 patients) or RP + RT (17.7%, 14/285 patients; P <0.01). Multivariate logistic regression analysis, adjusted for clinical and pathological variables, showed that patients from Central Italy (odds ratio [OR] 2.86; P <0.05) and South Italy (OR 2.65; P <0.05) were more likely to receive discordant ADT. Conclusion: EAU guideline adherence for ADT was low in Italy and was influenced by geographic area. Healthcare providers and urologists should consider these results in order to quantify the inadequate use of ADT and to set policy strategies to overcome this risk.

KW - Adherence

KW - Androgen deprivation therapy

KW - European Association of Urology

KW - Guidelines

KW - Prostate cancer

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DO - 10.1111/bju.13307

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JO - BJU International

JF - BJU International

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