Testosterone Replacement Per Guidelines PDF Download

Author: Durant Karen J.
Publisher:
ISBN:
Category : Evidence-based medicine
Languages : en
Pages : 0

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Book Description
Low testosterone (LT) levels affect approximately four million men in the United States, but only about 5% received treatment. Testosterone is the most important male sex hormone. It helps the body produce and maintain adult male features. Testosterone deficiency syndrome can cause significant morbidity and substantial reduction in quality of life. Testosterone therapy can be safe if appropriate evaluation is done prior to treatment and during therapy. Basin et al. and Darby and Anawalt emphasized that there is a need for a standardized plan for men receiving testosterone replacement therarpy. Drug manufacturers are bringing this issue to the public's attention through direct-to-consumer advertisement. Due to aggressive marketing to the public, it is urgent that an evidence-based protocol be implemented as an increasing number of men will be inquiring about testosterone replacement. The project addressed the question: Do adult males with testosterone deficiency syndrome received appropriate evaluation pre and post initiation of testosterone replacement therapy? To answer the question, and evidence-based standardized testosterone replacement protocol derived from the Endocrine Society's Guidelines for Testosterone Therapy in Adult Man with Androgen Deficiency Syndromes was implemented in an independent famil practice clinic. In the clinic, the number of men inquiring about testosterone deficiency and replacement has increased in the past few years. The evidence-based practice framework that was used to guide this project was derived from the Larrabee's Evidence-Based Practice Change Model. The Theory of Unpleasant Symptoms was selected to provide the theoretical guide for the project. Primary care providers implemented testosterone replacement per the Endocrine Society's Guidelines for Testosterone Therapy in Adult Men with Androgen Deficiency Syndromes. Practice change outcomes were evaluated through chart audit before and after implementation of the guidelines. Over a three month period of time a total of 22 charts were reviewed. Baseline evaluation found the majority of patients were having their initial testosterone check by providers per guidelines but few providers were ordering the confirmatory testosterone level as recommended in the guidelines. Few patients were receiving the recommended lab evaluation prior to starting replacement therapy/. Approximately one third of all patients over 40 had a pre or post therapy digital rectal exam. The majority had post initiation of therapy lab but the prostate specific antigen (PSA) was often not completed. Patient care providers and medical assistants willingly implemented the Endocrine Society Guidelines for Testosterone Therapy in Adult Men with Androgen Deficiency Syndromes. This was evident in the post evaluation as improved outcomes were identified.