R. Bultijnck, C. Surcel, G. Ploussard, A. Briganti, P. De Visschere, J.J. Fütterer, P. Ghadjar, G. Giannarini, H. Isbarn, C. Massard, P. Sooriakumaran, M. Valerio, R. van den Bergh & P. Ost
BACKGROUND: Evidence-based recommendations are available for the management of androgen deprivation therapy (ADT)-induced side effects; however, there are no data on the implementation of the recommendations into daily practice patterns.
OBJECTIVE: To compare practice patterns in the management of ADT-induced side effects with evidence-based strategies.
DESIGN, SETTING, AND PARTICIPANT: A European Web-based survey was conducted from January 16, 2015, to June 24, 2015. The 25-item questionnaire was designed with the aid of expert opinion and covered general respondent information, ADT preference per disease stage, patient communication on ADT-induced side effects, and strategies to mitigate side effects. All questions referred to patients with long-term ADT use. Reported practice patterns were compared with available evidence-based strategies.
OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Following data collection, descriptive statistics were used for analysis. Frequency distributions were compiled and compared using a generalised chi-square test.
RESULTS AND LIMITATIONS: In total, 489 eligible respondents completed the survey. Luteinising hormone-releasing hormone-agonist with or without an antiandrogen was the preferred method of ADT in different settings. Patients were well informed about loss of libido (90%), hot flushes (85%), fatigue (67%), and osteoporosis (63%). An osteoporotic and metabolic risk assessment prior to commencing ADT was done by one-quarter of physicians. The majority (85%) took preventive measures and applied at least one evidence-based strategy. Exercise was recommended by three-quarters of physicians who advocate its positive effects; however, only 25% of physicians had access to exercise programmes. Although the minimum sample size was set at 400 participants, the current survey remains susceptible to volunteer and nonresponder bias.
CONCLUSIONS: Patients were well informed about several ADT-induced complications but uncommonly underwent an osteoporotic and metabolic risk assessment. Nevertheless, physicians partially provided evidence-based strategies for the management of the complications. Physicians often advised exercise to reduce ADT-induced side effects, but programmes were not widely available.
PATIENT SUMMARY: Implementation of evidence-based strategies for androgen deprivation therapy-induced side effects in real-life practice patterns should be improved.