Introduction: Finasteride is a common medication used to treat benign prostatic hyperplasia (BPH). Clinical trials with finasteride demonstrate improved urinary symptoms and decreased need for surgical BPH treatment. Despite these benefits, its side effects and slow symptomatic improvement may lead to poor adherence. For these reasons, we conducted a study examining patient characteristics associated with long-term finasteride adherence.
Methods: We conducted a retrospective cohort of patients aged 40-100 years with a BPH diagnosis using Veterans Health Administration data from 2006 to 2014. We compared baseline characteristics of men taking finasteride to those not taking any BPH medications. We defined medication non-adherence as having less than 80% of prescription days covered over a two-year period. We used descriptive statistics and multivariable logistic regression to assess for patient-level adherence predictors.
Results: Our cohort comprised 490,631 Veterans with a BPH diagnosis. Just under ten percent (n=47,308) of patients were prescribed finasteride. Men taking finasteride were slightly older, White, Hispanic, and single. We found that less than half of the men were adherent to finasteride over the two-year study period. After adjustment, medication adherence was more common among men who were older (OR 1.01) and less healthy (comorbidity score 1 OR 1.20, comorbidity score 2+ OR 1.30), and less common amongst Black (OR 0.60), Hispanic (OR 0.60), and single (OR 0.81) patients.
Conclusions: Less than half of men with BPH in our cohort were adherent to finasteride at two years. Future research should investigate modifiable causes of non-adherence, and if these differences impact clinical outcomes. Source of
