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Call to action for BPH

ProState of the Nation is an evidence-based report, bringing the issues of under-management and under-treatment of Benign Prostatic Hyperplasia (BPH) front of mind among drivers of healthcare service delivery change

Published: 17 Oct 2011

ProState campaign

The report sought to improve effective diagnosis of BPH.

Client: GlaxoSmithKline

Agency: Packer Forbes Communications

Campaign: ProState of the Nation

Timescale: February to October 2009

A quick look

ProState of the Nation is an evidence-based report, bringing the issues of under-management and under-treatment of Benign Prostatic Hyperplasia (BPH) front of mind among drivers of healthcare service delivery change. The report reached 40,000 GPs and 40,000 payers through distribution in Pulse and HSJ. As a result of this report there has been evidence of real improvement in appropriate primary care prescribing, local service redesign and high-profile campaigning for inclusion of BPH on Quality and Outcomes Framework (QOF), all of which will ultimately result in improvements in more patient-focused, cost-effective, primary care led BPH management.

Challenge

Benign Prostatic Hyperplasia (BPH) is a condition affecting about 3.2 million men in the UK, a third of whom are over the age of 50. This number is set to rise with an ageing population. Although BPH can be effectively managed in primary care, it is under-diagnosed in this setting and commonly patients are referred directly to secondary care, resulting in substantial financial costs to the NHS and social costs to patients and their families. There is a significant unmet need for improvements in training and support for primary care physicians in order to encourage better management of BPH in primary care, at the same time as reducing unnecessary and costly secondary care referrals.

Solution

The ProState of the Nation report was developed to highlight the gaps in current understanding about BPH; a research analysis revealed extensive under-diagnosis and under-management of BPH in primary care, primarily due to lack of education and fear of misdiagnosis of the more serious condition – prostate cancer. A team of experts, including a consultant urologist, GPwSI, patient organisation (Prostate UK) and service commissioner, advised on the content of the report. It included visuals, quotes and case studies to educate about effective diagnosis of BPH and appropriate secondary care referrals. Using HES, IMS RSA data and advice from the London School of Economics, a cost-analysis was developed to highlight the benefits of treating BPH patients in a primary care setting and assess where cost savings could be made, while improving the quality of service for patients. The report was endorsed by the expert team who also developed a call-to-action to GPs for a change to their current management practices. The report reached 40,000 GPs and 40,000 payers through distribution with Pulse and HSJ.

Results

Evaluation of the use of the ProState of the Nation report suggests that GPs are starting to change their attitudes towards BPH in primary care. Many have altered prescribing and referral behaviours to ensure optimal treatment for their patient, which will also result in a reduction of costly secondary care management. Prostate UK showcased the report at a House of Commons event attended by 30 MPs, to highlight the issue and the need for prioritisation of BPH management in primary care. In addition, there is increased likelihood of BPH inclusion on the next Quality and Outcomes Framework (QOF), following questions in the House of Lords by Baroness Mary Archer; high-profile support from the Chairman of Cambridge University NHS Foundation Trust;  and a presentation of the report to the Clinical and Public Health Director of NICE.

Client verdict

"The ProState of the Nation report presents solid and compelling evidence for improving BPH management in the UK, which has been pivotal in helping drive BPH up the political agenda and has had a fantastic effect to date."

Emma Taylor, Senior Brand Manager, Urology, GSK

"The ProState of the Nation report demonstrates how, with appropriate training, support and resources GPs can do much to effectively manage and alleviate the condition. It is also a wake-up call to policy makers who have shied away from confronting BPH and makes a compelling case for the need for proactive diagnosis and intervention."

Amanda McLean, former CEO Prostate UK

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