CoastWatcher
Moderator
It's undeniably true that Excelmale's membership heavily favours injections as the preferred mode of therapy. Nonetheless, there are certainly men who have found success with topical testosterone applications (creams and gels) and many new members come to the community with questions about them. A recent study has been published in which commercially insured US men with a diagnosis of hypogonadism were investigated for adherence to topical testosterone applications. Baseline characteristics and follow-up outcomes between adherent and non-adherent patients were detailed.
Adherence to topical testosterone was low - cumulative rates of discontinuation at 1 year of approximately 80% were similar to those seen in previous retrospective analyses in the United States. A retrospective study in Canada reported 29% to 51% of men were still on topical testosterone at 1 year, depending on the formulation used.
Unsurprisingly, the authors concluded that adherent patients achieved higher levels of satisfaction. Adherent patients had a 45% greater increase in total testosterone than did those who abandoned treatment.
"Topical Testosterone Therapy Adherence and Outcomes Among Men With Primary or Secondary Hypogonadism," The Journal of Sexual Medicine, February 2018, http://www.jsm.jsexmed.org/article/S1743-6095(17)31849-0/fulltext?mobileUi=0
- 3,184 patients were included in the study.
- At the 12-month mark, only 17% were adherent to treatment.
- Factors positively associated with adherence included:
- Prescribing/treatment provided by specialists (endocrinologist, urologist) as opposed to a primary-care physician;
- Fewer comorbidities at baseline;
- Residence in the northeastern US;
- An earlier start-year of the topical prescription.
- Prescribing/treatment provided by specialists (endocrinologist, urologist) as opposed to a primary-care physician;
Adherence to topical testosterone was low - cumulative rates of discontinuation at 1 year of approximately 80% were similar to those seen in previous retrospective analyses in the United States. A retrospective study in Canada reported 29% to 51% of men were still on topical testosterone at 1 year, depending on the formulation used.
- Several factors can contribute to low adherence and persistence with therapy. The analysis indicates that patients whose first fill was prescribed by a specialist had higher odds of being adherent to topicals. This could be due to several reasons, such as the greater experience in diagnosing and follow-up associated with a specialist or greater impact on patients' behavior when being treated by a specialist.
- Presence of osteoporosis at baseline was associated with higher adherence, however presence of other comorbidities (such as thyroid abnormalities or diabetes) was associated with lower adherence.
- Older patients were less adherent than younger patients.
Unsurprisingly, the authors concluded that adherent patients achieved higher levels of satisfaction. Adherent patients had a 45% greater increase in total testosterone than did those who abandoned treatment.
"Topical Testosterone Therapy Adherence and Outcomes Among Men With Primary or Secondary Hypogonadism," The Journal of Sexual Medicine, February 2018, http://www.jsm.jsexmed.org/article/S1743-6095(17)31849-0/fulltext?mobileUi=0
