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Can Fam Physician
Vol. 53, No. 11, November 2007, pp.1936 - 1942
Copyright © 2007 by The College of Family Physicians of Canada
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Research

Androgen therapy

Testing before prescribing and monitoring during therapy

Alan Katz, MB ChB MSc CCFP FCFP
Research Director in the Department of Family Medicine at the University of Manitoba in Winnipeg and Associate Director of the Manitoba Centre for Health Policy

Anne Katz, RN PhD
Clinical Nurse Specialist at Cancer Care Manitoba

Charles Burchill, MSc
Manager of Program and Analysis Systems at the Manitoba Centre for Health Policy

Correspondence to: Dr Alan Katz, 408-727 McDermot Ave, Winnipeg, MB R3E 3P5; telephone 204 789-3442; e-mail Alan_Katz{at}cpe.umanitoba.ca

OBJECTIVE To explore the extent to which biochemical testing is used to diagnose androgen deficiency before initiating treatment and to learn whether recommendations for clinical monitoring of men taking androgen therapy are being followed.

DESIGN Population-based retrospective cohort study.

SETTING Winnipeg, Man.

PARTICIPANTS A total of 902 men who filled at least 2 prescriptions for androgen therapy.

MAIN OUTCOME MEASURES Whether men had had baseline prostate-specific antigen (PSA) and testosterone testing before initiation of therapy and whether men had beenmonitored during the first year of treatment.

RESULTS Of the 902 men who filled first-time prescriptions during the study period, only 475 (52.7%) had ever had PSA or testosterone tests. Before starting therapy, 315 men (34.9%) had had PSA tests, and 152 men (16.9%) had had testosterone tests. Less than 1% of the entire sample had had 3 or more tests during the year following initiation of therapy.

CONCLUSION Indications for androgen therapy in this population appear to be based on clinical symptoms rather than on demonstrated biochemical androgen deficiency. Recommendations for clinical monitoring of men taking androgen therapy are not followed consistently.






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