Show simple item record

Files in this item


Item metadata

dc.contributor.authorHassoun, Omar
dc.contributor.authorStarostka, Matt
dc.contributor.authorShearer, Heather
dc.contributor.authorMillar, Angela
dc.contributor.authorHassoun, Salman
dc.contributor.authorIsles, Chris
dc.identifier.citationHassoun , O , Starostka , M , Shearer , H , Millar , A , Hassoun , S & Isles , C 2022 , ' Improving the annual monitoring rates of testosterone replacement therapy patients in primary care ' , BMJ Open Quality , vol. 11 , no. 3 , e001784 .
dc.identifier.otherPURE: 280812450
dc.identifier.otherPURE UUID: 80bb92c5-8f4b-4314-a164-7262effaad40
dc.identifier.otherJisc: 499744
dc.identifier.otherpublisher-id: bmjoq-2021-001784
dc.identifier.otherScopus: 85135337425
dc.identifier.otherWOS: 000835366200001
dc.description.abstractIntroduction Testosterone replacement therapy (TRT) is the treatment of choice for male hypogonadism. British Society for Sexual Medicine (BSSM) guidelines on adult testosterone deficiency recommend that TRT patients undergo annual monitoring of their testosterone levels and potential complications of treatment; though evidence suggests that substantial numbers of men on TRT are not monitored adequately. Methods Review of the electronic patient record from a single general practice in southwest Scotland revealed that only 1 of 26 (4%) TRT patients had been monitored as per BSSM guidelines in the previous 12 months. Additionally, when monitoring was undertaken there was inconsistency in the blood tests requested. The use of quality improvement (QI) tools including process mapping and cause-and-effect diagram identified staff and patient knowledge of monitoring requirements and the lack of an effective recall system as areas for improvement. We tested three change ideas: the utilisation of an existing recall system for long-term therapies; a TRT Ordercomms blood group template (OBGT) to standardise monitoring; and a patient information leaflet (PIL) to improve patient education. The aim of this project was to achieve 60% annual monitoring rate. Results The percentage of patients monitored for testosterone levels and potential TRT complications increased from 4% (1/26) to 65% (17/26) over a 7-week test period. The utilisation of the existing recall system was a particularly effective intervention, leading to an increase from 4% (1/26) to 31% (8/26) in the first 2 weeks. Conclusion The use of QI tools was associated with over 60% of male TRT patients receiving comprehensive annual monitoring, as per BSSM guidelines. Our findings support the hypothesis that a patient recall system, combined with an OBGT and a PIL led to this increase.
dc.relation.ispartofBMJ Open Qualityen
dc.rightsCopyright © Author(s) (or their employer(s)) 2022. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See:
dc.subjectRA Public aspects of medicineen
dc.titleImproving the annual monitoring rates of testosterone replacement therapy patients in primary careen
dc.typeJournal articleen
dc.description.versionPublisher PDFen
dc.contributor.institutionUniversity of St Andrews. School of Medicineen
dc.contributor.institutionUniversity of St Andrews. Education Divisionen
dc.description.statusPeer revieweden

This item appears in the following Collection(s)

Show simple item record