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Patterns of testosterone prescription overuse

Jasuja, Guneet K.a,b; Bhasin, Shalenderc; Rose, Adam J.d,e

Current Opinion in Endocrinology & Diabetes and Obesity: June 2017 - Volume 24 - Issue 3 - p 240–245
doi: 10.1097/MED.0000000000000336
ANDROGENS: Edited by David Handelsman

Purpose of review There has been an increase in the prescribing of testosterone therapy in the past decade. There is concern that at least part of this increase is driven by advertising rather than sound medical practice. The purpose of this review is to summarize the recent trends in testosterone prescribing, and to examine whether testosterone is being appropriately prescribed as per guidelines.

Recent findings Both global and U.S. data reflect an overall increase in the use of testosterone in the last decade, although there are early signs of a decline in testosterone sales since 2014. This increased prescribing has been accompanied with an overall increase in testing for testosterone levels, prescription of testosterone without the appropriate diagnostic evaluation recommended by clinical practice guidelines, and apparent use of this therapy for unproven medical conditions.

Summary Research to date suggests that there is room to improve our prescribing of testosterone. Greater understanding of the potential provider-level and system-level factors that contribute to the current prescribing practices may help accomplish such improvement.

aCenter for Healthcare Organization and Implementation Research (CHOIR), ENRM VAMC, Bedford.

bDepartment of Health Law, Policy and Management, Boston University School of Public Health, Boston

cResearch Program in Men's Health, Aging and Metabolism, Boston Claude D. Pepper Older Americans Independence Center, Brigham and Women's Hospital, Harvard Medical School, Boston

dRAND Corporation, Boston, MA

eDepartment of Medicine, Section of General Internal Medicine, Boston University School of Medicine, Boston, Massachusetts, USA

Correspondence to Guneet K. Jasuja, PhD, Center for Healthcare Organization and Implementation Research, Bedford VA Medical Center, 200 Springs Road, Bedford, MA 01730, USA. Tel: +1 781 687 2767; fax: +1 781 687 3106; e-mail: guneet.jasuja@va.gov

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