Testosterone Rx May be Influenced by Provider, Site
Testosterone use was also more likely at sites located in the West vs the Northeast and for care received at a community-based outpatient clinic versus a medical center.
(HealthDay News) — Provider- and site-level factors, including experience, specialty, and site location, are associated with testosterone prescribing, according to a study published online in the Journal of Clinical Endocrinology and Metabolism.
Guneet K. Jasuja, PhD, from the Center for Healthcare Organization and Implementation Research in Bedford, Mass., and colleagues conducted a cross-sectional study to examine provider- and site-level determinants of testosterone receipt in a national cohort of male patients. Participants received at least one outpatient prescription within the Veterans Health Administration (VA); 38,659 providers and 130 stations were associated with the patients.
The researchers found that the likelihood of prescribing testosterone was increased for providers ranging in age from 31 to 60 years, with less experience in the VA (all adjusted odds ratios (aORs), <2.0), and credentialed as physicians in endocrinology and urology (aORs, 3.86 and 1.50, respectively), compared with older providers, providers of longer VA tenure, and primary care providers, respectively. Testosterone use was also more likely at sites located in the West vs the Northeast (aOR, 1.75) and for care received at a community-based outpatient clinic versus a medical center (aOR, 1.22). Compared with primary care providers, endocrinologists were also more likely to obtain an appropriate work-up before prescribing (aOR, 2.14).
"Our results highlight the opportunity to intervene both at the provider and the site level to improve testosterone prescribing," the authors write. "Beyond testosterone, this study provides a useful example of how to examine contributions to prescribing variation at different levels of the health care system."
Several authors disclosed financial ties to the pharmaceutical industry.
- Jasuia GK, Bhasin S, Rose AJ, et al. Provider and Site-Level Determinants of Testosterone Prescribing in the Veterans Healthcare System. J Clin Endocrinol Metab. 18 July 2017. DOI: 10.1210/jc.2017-00468