Topical Testosterone Therapy Adherence and Outcomes Among Men With Primary or Secondary Hypogonadism
Abstract
BACKGROUND: Men with primary or secondary hypogonadism (HG) prescribed testosterone therapy (TTh) who terminate treatment early might not obtain the benefit of symptom relief.
AIM: To estimate adherence to topical TTh and to compare baseline characteristics and follow-up outcomes between adherent and non-adherent patients in a population of commercially insured US men with primary or secondary HG.
METHODS: A retrospective cohort of adult men with primary or secondary HG and initiating topical TTh from 2007 through 2014, with continuous coverage during 12-month baseline and follow-up periods, was identified from a large US health plan. Clinical conditions were assessed using International Classification of Diseases, 9th Revision, Clinical Modification codes. Adherence to initial topical TTh was defined as proportion of days covered of at least 80%. Characteristics and outcomes were compared across adherent and non-adherent patients.
OUTCOMES: Adherence to topical TTh, occurrence of HG-related clinical outcomes, and total health care costs.
RESULTS: We identified 3,184 topical TTh initiators (mean age = 49 years), of whom 17% (n = 538) were adherent at 12 months. Factors positively associated with adherence included prescribing by specialists, a lower prevalence of certain comorbidities at baseline, residence in the Northeast, and an earlier start year of the topical TTh prescription. Adherence to topical TTh was associated with lower odds of having HG-associated clinical…
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 538 participants or records.
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