Skip to main content
NCBI home page
Canadian Family Physician logoLink to Canadian Family Physician
. 2000 Feb;46:383–389.

Managing benign prostatic hyperplasia in primary care. Patient-centred approach.

J McSherry 1, R Weiss 1
PMCID: PMC1987686  PMID: 10690495

Abstract

PROBLEM ADDRESSED: Management of benign prostatic hyperplasia (BPH) is changing from a surgical approach to a medical approach, and the role of primary care physicians is expanding. OBJECTIVE OF PROGRAM: To introduce a patient-centred approach to managing BPH in primary care through a continuing medical education (CME) program. MAIN COMPONENTS OF PROGRAM: A practice-based, small group, peer-led CME program focused on application of the International Prostate Symptom Score and Quality of Life Assessment in four case studies on prostatism, including BPH. At 86 workshops held across Canada, 658 physicians participated in discussions with case materials that included videos and a handbook. A before-after practice behaviour questionnaire was administered at each workshop to evaluate "intent to change." CONCLUSIONS: Participating physicians showed willingness to learn new skills for patient-centred management of BPH. These results suggest that peer-led, small group CME can successfully encourage use of new practice guidelines in primary are and teach physicians practical steps for developing therapeutic alliances with their patients.

Full text

PDF
383

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Barry M. J., Fowler F. J., Jr, O'Leary M. P., Bruskewitz R. C., Holtgrewe H. L., Mebust W. K., Cockett A. T. The American Urological Association symptom index for benign prostatic hyperplasia. The Measurement Committee of the American Urological Association. J Urol. 1992 Nov;148(5):1549–1564. doi: 10.1016/s0022-5347(17)36966-5. [DOI] [PubMed] [Google Scholar]
  2. Berry S. J., Coffey D. S., Walsh P. C., Ewing L. L. The development of human benign prostatic hyperplasia with age. J Urol. 1984 Sep;132(3):474–479. doi: 10.1016/s0022-5347(17)49698-4. [DOI] [PubMed] [Google Scholar]
  3. Conroy M., Shannon W. Clinical guidelines: their implementation in general practice. Br J Gen Pract. 1995 Jul;45(396):371–375. [PMC free article] [PubMed] [Google Scholar]
  4. Davis D. A., Thomson M. A., Oxman A. D., Haynes R. B. Changing physician performance. A systematic review of the effect of continuing medical education strategies. JAMA. 1995 Sep 6;274(9):700–705. doi: 10.1001/jama.274.9.700. [DOI] [PubMed] [Google Scholar]
  5. Davis D. A., Thomson M. A., Oxman A. D., Haynes R. B. Evidence for the effectiveness of CME. A review of 50 randomized controlled trials. JAMA. 1992 Sep 2;268(9):1111–1117. [PubMed] [Google Scholar]
  6. Girman C. J., Jacobsen S. J., Guess H. A., Oesterling J. E., Chute C. G., Panser L. A., Lieber M. M. Natural history of prostatism: relationship among symptoms, prostate volume and peak urinary flow rate. J Urol. 1995 May;153(5):1510–1515. doi: 10.1016/s0022-5347(01)67448-2. [DOI] [PubMed] [Google Scholar]
  7. Lewis S. Paradox, process and perception: the role of organizations in clinical practice guidelines development. CMAJ. 1995 Oct 15;153(8):1073–1077. [PMC free article] [PubMed] [Google Scholar]
  8. McConnell J. D., Barry M. J., Bruskewitz R. C. Benign prostatic hyperplasia: diagnosis and treatment. Agency for Health Care Policy and Research. Clin Pract Guidel Quick Ref Guide Clin. 1994 Feb;(8):1–17. [PubMed] [Google Scholar]
  9. McConnell J. D., Bruskewitz R., Walsh P., Andriole G., Lieber M., Holtgrewe H. L., Albertsen P., Roehrborn C. G., Nickel J. C., Wang D. Z. The effect of finasteride on the risk of acute urinary retention and the need for surgical treatment among men with benign prostatic hyperplasia. Finasteride Long-Term Efficacy and Safety Study Group. N Engl J Med. 1998 Feb 26;338(9):557–563. doi: 10.1056/NEJM199802263380901. [DOI] [PubMed] [Google Scholar]
  10. McPhee S. J., Bird J. A., Fordham D., Rodnick J. E., Osborn E. H. Promoting cancer prevention activities by primary care physicians. Results of a randomized, controlled trial. JAMA. 1991 Jul 24;266(4):538–544. [PubMed] [Google Scholar]
  11. Mittman B. S., Tonesk X., Jacobson P. D. Implementing clinical practice guidelines: social influence strategies and practitioner behavior change. QRB Qual Rev Bull. 1992 Dec;18(12):413–422. doi: 10.1016/s0097-5990(16)30567-x. [DOI] [PubMed] [Google Scholar]
  12. Needham D. R., Begg I. M. Problem-oriented training promotes spontaneous analogical transfer: memory-oriented training promotes memory for training. Mem Cognit. 1991 Nov;19(6):543–557. doi: 10.3758/bf03197150. [DOI] [PubMed] [Google Scholar]
  13. Oesterling J. E. Benign prostatic hyperplasia. Medical and minimally invasive treatment options. N Engl J Med. 1995 Jan 12;332(2):99–109. doi: 10.1056/NEJM199501123320207. [DOI] [PubMed] [Google Scholar]
  14. Oxman A. D., Thomson M. A., Davis D. A., Haynes R. B. No magic bullets: a systematic review of 102 trials of interventions to improve professional practice. CMAJ. 1995 Nov 15;153(10):1423–1431. [PMC free article] [PubMed] [Google Scholar]
  15. Premi J., Shannon S., Hartwick K., Lamb S., Wakefield J., Williams J. Practice-based small-group CME. Acad Med. 1994 Oct;69(10):800–802. doi: 10.1097/00001888-199410000-00002. [DOI] [PubMed] [Google Scholar]
  16. Reznick R. K., Smee S., Baumber J. S., Cohen R., Rothman A., Blackmore D., Bérard M. Guidelines for estimating the real cost of an objective structured clinical examination. Acad Med. 1993 Jul;68(7):513–517. doi: 10.1097/00001888-199307000-00001. [DOI] [PubMed] [Google Scholar]
  17. Wilson D. M., Taylor D. W., Gilbert J. R., Best J. A., Lindsay E. A., Willms D. G., Singer J. A randomized trial of a family physician intervention for smoking cessation. JAMA. 1988 Sep 16;260(11):1570–1574. [PubMed] [Google Scholar]

Articles from Canadian Family Physician are provided here courtesy of College of Family Physicians of Canada

RESOURCES