Testosterone Therapy: Adhering to Treatment/Modes of Treatment

CoastWatcher

Moderator
An older study, but one worth considering.

To determine which modes of treatment resulted in the highest rates of adherence, a retrospective claims database study from January 2005 through December 2011 was undertaken. The study included 106,039 men, 18-65 years of age who had initiated TRT and were diagnosed with hypogonadism or hypogonadotropic hypogonadism. A minimum of 6 months continuous enrollment before and 12 months after the TRT index date was required. Adherence was measured by the Mediation Possession Ratio (MPR) and the Proportion of Days Covered (PDC), with the adherence rate defined as MPR≥0.8. The rate of the first switching was summarized by TRT formulation.

  • The overall adherence rate over 12 months was 21.4% ranging from 28% (pellets), 19.9% (SAIs), 17.7% (gels), 7.8% (buccal), and 6.6% (patch), respectively. Similarly, the average PDCs were significantly higher for pellets (0.59) compared to gels (0.43), SAIs (0.39), buccal (0.28), and patch (0.27) (P<0.001). About 13% (n = 13,577) of patients switched from their initial therapy to a different TRT formulation. Patients starting with patch were most likely to switch to a different formulation (39.3%), followed by patients with SAIs (12.1%), pellets/buccal (12.0%), and gels (10.3%).

"Medication adherence and switching rates of patients with testosterone replacement therapy (TRT) in the United States," Value in Health Journal, May 2014, http://www.valueinhealthjournal.com/article/S1098-3015(14)01586-1/fulltext
 
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wow, if I am understanding this correctly, it is no wonder that some men have horrible experiences on TRT with such low adherence rates. Do you think pellets are so high just because you really have no choice but to adhere?
 

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TRT Hormone Predictor Widget

TRT Hormone Predictor

Predict estradiol, DHT, and free testosterone levels based on total testosterone

⚠️ Medical Disclaimer

This tool provides predictions based on statistical models and should NOT replace professional medical advice. Always consult with your healthcare provider before making any changes to your TRT protocol.

ℹ️ Input Parameters

Normal range: 300-1000 ng/dL

Predicted Hormone Levels

Enter your total testosterone value to see predictions

Results will appear here after calculation

Understanding Your Hormones

Estradiol (E2)

A form of estrogen produced from testosterone. Important for bone health, mood, and libido. Too high can cause side effects; too low can affect well-being.

DHT

Dihydrotestosterone is a potent androgen derived from testosterone. Affects hair growth, prostate health, and masculinization effects.

Free Testosterone

The biologically active form of testosterone not bound to proteins. Directly available for cellular uptake and biological effects.

Scientific Reference

Lakshman KM, Kaplan B, Travison TG, Basaria S, Knapp PE, Singh AB, LaValley MP, Mazer NA, Bhasin S. The effects of injected testosterone dose and age on the conversion of testosterone to estradiol and dihydrotestosterone in young and older men. J Clin Endocrinol Metab. 2010 Aug;95(8):3955-64.

DOI: 10.1210/jc.2010-0102 | PMID: 20534765 | PMCID: PMC2913038

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