(218) PHYSICIAN AWARENESS AND INDICATIONS OF 5-ALPHA REDUCTASE INHIBITOR USE FOR BENIGN PROSTATIC HYPERPLASIA IN THE PRIMARY CARE SETTING

Abstract Introduction Primary care physicians (PCPs) commonly prescribe 5-alpha-reductase inhibitors (5-ARIs) for benign prostatic hyperplasia (BPH). 5-ARIs can affect prostate-specific antigen (PSA) kinetics by decreasing PSA levels by approximately half, and therefore delay early detection of prostate cancer (PCa). Our team previously presented preliminary findings revealing a general low level of knowledge regarding the effects of 5-ARIs on PSA kinetics. Objective Thus, the objective of this study is to now present further, expanded data investigating PCPs’ level of awareness and indications of 5 ARI use for BPH in the primary care setting. Methods An anonymous 14-question survey was emailed to PCPs in the specialties of Family Medicine or Internal Medicine at a diverse, urban academic institution. Questions focused on residency graduation year, patient volume, medical practice characteristics, knowledge of 5-ARIs and their effects on PSA kinetics, role of 5-ARIs in PCa prevention, and indications for prostate biopsy referral. Results 221 PCPs were emailed. Overall, 85 PCPs responded, yielding a response rate of 38.5%. All PCPs reported to see men >40 years of age and the majority (78.8%) reported to have prescribed 5-ARIs in practice. Approximately 39% of PCPs were not aware of the suppressive effects of 5-ARIs on PSA and 63.5% were not sure or incorrectly answered when asked about calculating the corrected PSA of a patient who is taking 5-ARIs. Furthermore, nearly 80% were not sure or would not refer a patient who is taking 5-ARIs and has an elevated corrected PSA for a prostate biopsy. 63.5% were not sure or believed that 5-ARIs may decrease the risk of high-grade PCa and 49.4% were not sure or believed that 5-ARIs are approved for the prevention of PCa. Conclusions Overall, our expanded culmination of data within an academic, urban institution reveals a low level of knowledge amongst PCPs as it relates to the effect of 5 ARIs on PSA kinetics and subsequently the indications for biopsy referral in these patients. Thus, this gap in knowledge may represent an important initiative to work with our primary care colleagues in caring for patients taking 5 ARIs for BPH. Disclosure No.