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UPJ INSIGHT Enhancing the Management of Benign Prostatic Hyperplasia

By: Denzel Zhu, MD, University of Rochester Medical Center, New York; Kaela Mali, BA, University of Rochester School of Medicine and Dentistry, New York; Jathin Bandari, MD, University of Rochester Medical Center, New York; Rajat K. Jain, MD, University of Rochester Medical Center, New York; Scott O. Quarrier, MD, MPH, University of Rochester Medical Center, New York | Posted on: 17 Jul 2024

Zhu D, Mali K, Bandari J, Jain RK, Quarrier SO. Enhancing the management of benign prostatic hyperplasia: the role of electronic health record patient portal distribution of the International Prostate Symptom Score. Urol Pract. 2024;11(4):709-715. doi:10.1097/UPJ.0000000000000573

Study Need and Importance

Recent AUA guidelines for the management of benign prostatic hyperplasia (BPH) recommend routine collection of the International Prostate Symptom Score (IPSS) for evaluating BPH-related symptoms, but manual collection poses logistical barriers. Electronic patient portals (EPP) are web portals used to facilitate health care system–patient communication. Recognizing the potential of EPP to streamline this process, the study aims to assess the impact of distribution of IPSS by the EPP on IPSS completion rates and subsequent BPH management.

What We Found

We found that EPP distribution of IPSS significantly increased IPSS completion rates, thereby improving adherence to AUA guidelines. Collection of the IPSS by EPP increased the detection of men with severe BPH. Completion of IPSS was associated with reduced time to BPH surgery and increased incidence of BPH surgery at 6 months (Figure).

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Figure. Kaplan-Meier cumulative incidence curves comparing rate of benign prostatic hyperplasia (BPH) surgery incidence among patients’ pre–electronic patient portal (EPP). Patients were followed from time to new patient visit to their date of BPH surgery or last follow-up.

Limitations

Limitations of the study include its retrospective nature and the potential impact of the COVID-19 pandemic on surgical scheduling and provider practice patterns. In addition, the patient portal distribution was limited to English-language IPSS.

Interpretation for Patient Care

The study suggests that EPP distribution of IPSS can effectively increase IPSS completion rates, improving adherence to AUA guidelines. Furthermore, this study demonstrates that improved IPSS completion may optimize BPH evaluation and treatment.

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