Crazy study regarding TRT adherence in general population

[HRTstudent]

Medication Adherence and Treatment Patterns for Hypogonadal Patients Treated with Topical Testosterone Therapy: A Retrospective Medical Claims Analysis

Michael Jay Schoenfeld MA*, Emily Shortridge PhD, Zhanglin Cui PhD, David Muram MD

Article first published online: 6 MAR 2013


http://onlinelibrary.wiley.com/doi/1...12114/abstract

Abstract


Introduction

There is limited information on adherence to topical testosterone replacement therapy (TRT) among hypogonadal men.


Aim

To determine adherence rates among men treated with topical testosterone gels and to examine factors that may influence adherence, including age, presence of a specific diagnosis, and index dose.


Methods

Included were 15,435 hypogonadal men, from the Thomson Reuters MarketScan® Database, who had an initial topical testosterone prescription in 2009 and who were followed for 12 months.


Main Outcome Measures

Adherence to testosterone was measured by medication possession ratio (MPR), with high adherence defined as ≥0.8. Persistence was defined as the duration of therapy from the index date to the earliest of the following events: end date of the last prescription, date of the first gap of >30 days between prescriptions, or end of the study period (12 months).
Results

Adherence to topical TRT was low. By 6 months, only 34.7% of patients had continued on medication; at 12 months, only 15.4%. Adherence rates were numerically similar among men who received AndroGel® or Testim® topical gels and did not differ among men of different age groups. Approximately 80% of patients initiated at the recommended dose of 50 mg/day. Over time, an increased proportion of men used a higher dose. This change was the result of dose escalation, rather than of greater adherence among men initiating therapy at a high dose. Dose escalation was seen as early as 1 month into therapy. Approximately 50% of men who discontinued treatment resumed therapy; most men used the same medication and dose.


Conclusions

Discontinuation rates are high among hypogonadal men treated with testosterone gels, irrespective of their age, diagnosis, and index dose. Further study, evaluating other measurable factors associated with low adherence among patients receiving topical TRT, may lead to interventions designed to improve adherence with therapy.



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It is interesting, although not particularly useful for us. It reaffirms my beliefs that a) most doctors know nothing about TRT, and b) the informed patients who post on forums are the incredible minority.

[Trific]

Wow, surprisingly low adherence...

Thanks TRT!

[EverettCD]

I agree with ya, I bet the % of men on TRT that read & post on the forum are minimal. Most just go with what their Docs tell them & ASSume that's as good as it gets.

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[38onTRT]

This is sad. A problem I have with docs is they don't seem to want to fix the issues, without meds or pills. They immediately turn to a statin or beta blocker type drug without looking at why you are having the issue in the first place. Obesity is at an all time high yet all they want to do is issue a script for all the underlying issues to cover up your problems. You, then continue to do harm to your self and not actually fix the problem at hand.. A bit off topic yes however wtf are our so called trusted docs doing, thinking and why..?

[EverettCD]

I have always wondered what kickbacks and/or perks the pharmaceutical companies are giving these Docs to "push" their meds???

Have you ever seen a Pharmaceutical Sales Rep that wasn't a smoking hot woman??? I haven't.

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[APIs]

I'm not surprised. Let's face it; TRT requires a level of commitment & personal responsibility of the patient which most are incapable of doing long-term. Hell, you can’t even get most people to take a daily vitamin never mind applying a sloppy gel every morning. Combine this with improper care & follow-up by many physicians and it’s doomed to fail from the beginning…

[kelkel]

I have always wondered what kickbacks and/or perks the pharmaceutical companies are giving these Docs to "push" their meds???

Have you ever seen a Pharmaceutical Sales Rep that wasn't a smoking hot woman??? I haven't.

Sent from my iPhone that was manufactured in a sweat shop in China

X2. So true. Love to attend one of their conventions....

[junk2222yard]

Adherence to topical TRT was low. By 6 months, only 34.7% of patients had continued on medication; at 12 months, only 15.4%. Adherence rates were numerically similar among men who received AndroGel® or Testim® topical gels and did not differ among men of different age groups.

Not surprising to me. I am one of those that dropped off after a month and started shots.

I don't think topical TRT will last. Too much trouble, too much risk, and too much of a crap shoot regarding performance. It is so unscientific the way you slather on a T ointment and hope for the best absorption-wise. Then there are the worries about transferring it to your wife and kids. And the smell of Testim not only was overpowering to me, it soaked into shirts and smelled even after laundering!

Personally, I don't think it ever should have been approved for use.

[HRTstudent]

Some women thought that testim smelled good... asked what fragrance it was lol.

"Oh? Im not wearing cologne." lol

Overall though I thought Testim sucked ass. If I didn't care more about my health I could easily see a person just stop taking that stuff. Didn't feel better, cost a lot, and was a significant inconvenience to me.

[steroid.com 1]

Not surprising to me. I am one of those that dropped off after a month and started shots.

I don't think topical TRT will last. Too much trouble, too much risk, and too much of a crap shoot regarding performance. It is so unscientific the way you slather on a T ointment and hope for the best absorption-wise. Then there are the worries about transferring it to your wife and kids. And the smell of Testim not only was overpowering to me, it soaked into shirts and smelled even after laundering!

Personally, I don't think it ever should have been approved for use.

Very well stated.

[Rusty11]

Another example of, "we're all different".

[61er]

The 1.62 Androgel commercial pitches the product in such a casual way. I can imagine a lot of guys giving it a try simply because they have low T. Unless you're suffering (depression, libido, etc.), it may seem like a pointless daily regimen after a couple of months.

[Brazensol]

I wonder how those rates compare to those of us who inject?

[HRTstudent]

The 1.62 Androgel commercial pitches the product in such a casual way. I can imagine a lot of guys giving it a try simply because they have low T. Unless you're suffering (depression, libido, etc.), it may seem like a pointless daily regimen after a couple of months.

Canada actually got in trouble a last year for making the Androgel ads too casual, as you say.

And I agree. it's a joke my t was low so I simply "turned it up". What a gimmick... but that is big pharma for you. This will not change any time soon as long as they are allowed to get away with it.

[Vahevahe]

This is sad. A problem I have with docs is they don't seem to want to fix the issues, without meds or pills. They immediately turn to a statin or beta blocker type drug without looking at why you are having the issue in the first place. Obesity is at an all time high yet all they want to do is issue a script for all the underlying issues to cover up your problems. You, then continue to do harm to your self and not actually fix the problem at hand.. A bit off topic yes however wtf are our so called trusted docs doing, thinking and why..?

I have been preaching this to anyone that will listen. MOST doctors treat the symptoms and not the underlying cause of the disease. I compare it to a tree that is growing and the doctor not uprooting the tree(problem) hes is just shaving off branches. I have felt this with the treatment of trt and im scared to visualize how many people are on other "behavior medication" which actually have a underlying medical condition. This goes beyond TRT and really hits on the fabric of the American medical system and tells us home much of a way we have to go. Gotta love capitalism.

[cornfedboy2000]

The 1.62 Androgel commercial pitches the product in such a casual way. I can imagine a lot of guys giving it a try simply because they have low T. Unless you're suffering (depression, libido, etc.), it may seem like a pointless daily regimen after a couple of months.

and here I sit... no libido, trouble gaining mass, yada yada yada, BW 3 years ago I was at 273, BW 2 weeks ago I was at 163... doc says "so do you want TRT?" and of course I jumped on it. Now I'm back pedalling like crazy trying to find out all the information I should have known before hand. I fully admit I was sucked in by the big Pharma, not to say I don't have a real problem, but as I'm finding out very quickly here, I need to find the underlying issue. This is the second time I've been prescribed something without all the infomation... the first was shortly after my last set of reconstructive surgeries on my leg (partially severed from motorcycle accident). This nerve blocker they prescribed has a wonderful side effect of MASSIVE weight gain. I'm getting sick of doctors making me worse. Well, off to do more research so I can blast my doc tomorrow.

[Rusty11]

^^^^Hang in there, bud. Your main concern right now is the issue you mentioned in your thread. Regarding gels, despite what you read here, they aren't worthless. I've been on Testim for over a year. My levels were around 650-700. I added hCG, and they now hover in the 800-900 level. My e2 remains 30-35. I've been feeling great for quite some time. I'm 51 and feel better than I ever have. I've been offered injections, but decided "if it ain't broke, don't fix it". Your time woll come. You've come to the right place to educate yourself.

Edit: a year ago, I was skinny/fat, no muscle, had insomnia, and a T level of 229.

[cornfedboy2000]

thanks, I guess right now I need to worry about getting some more blood work and figure out where my levels are, or at least demand a copy of the one they already took... still unsure of what all it had on it, but I assume it was limited. I might have jumped the gun on my other thread anyway. Right now I think I'm rushing everything, and i need to calm down, get information, and then go after it. I figure I'll stay on the gel while I figure stuff out, 50/50 shot right?