美国泌尿外科协会和内分泌学会于2018年发布了睾酮缺乏管理指南。睾酮处方模式最近变化很大,由于公众的兴趣增加和睾酮治疗安全性的新数据。指南公布对睾酮处方的影响尚不清楚。因此,我们旨在利用Medicare处方数据评估睾酮处方趋势.分析了2016-2019年超过100名睾丸激素处方的专业。包括9个专业(按处方频率递减的顺序):家庭实践,内科,泌尿科,内分泌学,执业护士,医师助理,一般实践,传染病,和急诊医学。开处方者的数量平均每年增长8.8%。从2016年到2019年,每位提供商的平均索赔额显著增加(26.4至28.7,p<0.0001),增长最快的发生在2017年至2018年指南发布时(27.2至28.1,p=0.015)。每个提供者的索赔增加最大的是泌尿科医师。高级执业提供者在2016年占Medicare睾丸激素索赔的7.5%,在2019年占11.6%。虽然不能确定因果关系,这些结果表明,专业社会指南与每个提供者的睾丸激素索赔数量增加有关,尤其是泌尿科医生。处方者不断变化的人口统计数据证明有针对性的教育和进一步研究是合理的。
The American Urological Association and Endocrine Society published
guidelines for the management of
testosterone deficiency in 2018. Testosterone prescription patterns have varied widely recently, owing to increased public interest and emerging data on the safety of testosterone therapy. The effect of
guideline publication on
testosterone prescribing is unknown. Thus, we aimed to assess testosterone prescription trends using Medicare prescriber data. Specialties with over 100 testosterone prescribers from 2016-2019 were analyzed. Nine specialties were included (in order of descending prescription frequency): family practice, internal medicine, urology, endocrinology, nurse practitioners, physician assistants, general practice, infectious disease, and emergency medicine. The number of prescribers grew by a mean of 8.8% annually. There was a significant increase in average claims per provider from 2016 to 2019 (26.4 to 28.7, p < 0.0001), with the steepest increase occurring between 2017 and 2018 when the
guidelines were released (27.2 to 28.1, p = 0.015). The largest increase in claims per provider was among urologists. Advanced practice providers comprised 7.5% of Medicare testosterone claims in 2016 and 11.6% in 2019. While no causation can be established, these results suggest that professional society
guidelines are associated with increasing numbers of testosterone claims per provider, especially among urologists. The changing demographics of prescribers justifies targeted education and further research.