Presented by: Scott Quarrier MD, MPH
Department of Urology, University of Rochester Medical Center

Introduction

Recent American Urological Association (AUA) guidelines for the initial evaluation of benign prostatic hyperplasia (BPH) recommend the routine collection of symptom score data by validated questionnaires. We hypothesize that distribution of questionnaires through an electronic patient portal (EPP) will increase patient completion of the questionnaires allowing for improved institutional adherence to AUA guidelines.  

Materials

We performed a retrospective, cross-sectional study of men undergoing a new patient visit (NPV) for a chief complaint of lower urinary tract symptoms (LUTS) at an academic medical center. On January 2021, we initiated distribution of International Prostate Symptom Score (IPSS) questionnaires through the EPP 7 days prior to the NPV; previously, IPSS was distributed in paper at the NPV. Primary outcome measure was the completion of the IPSS; secondary outcomes included new BPH medication or surgery scheduled within 6 months of the NPV. The χ²-test was used to compare outcomes.  

Results

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We reviewed 494 NPV for BPH, 255 NPV occurred prior to EPP collection and 239 NPV occurred after. Pre-EPP collection, only 37% (N=93) of IPSS scores were collected; this increased to 57% (N=136) following EPP collection (p<0.0001). The prevalence of severe LUTS based on IPSS (≥20) was higher post-EPP (41%) compared to pre-EPP (29%) collection (p=0.04). Following routine EPP collection of the IPSS, fewer patients (4%) had new BPH medications ordered during the NPV (10.2%, p=0.014); however, more patients had BPH surgery scheduled within 6 months (19% vs 9%, p=0.001).

Conclusion

Our study demonstrated that distribution of validated questionnaires via EPP significantly increased completion rate of the IPSS in patients undergoing evaluation for LUTS, increasing compliance with AUA guidelines. Routine EPP collection may help detect more severe disease and reduce time-to-intervention. Limitations include the COVID-19 pandemic possibly confounding surgical management, as well as its retrospective nature.

Funding

No external sources of funding supported this research. 

Lead Authors

Denzel Zhu, MD
Department of Urology, University of Rochester Medical Center

Co-Authors

Kaela Mali,
University of Rochester School of Medicine & Dentistry

Jathin Bandari, MD
Department of Urology, University of Rochester Medical Center

Rajat Jain, MD
Department of Urology, University of Rochester Medical Center