Patient's quality of life and coping style influence general practitioner's management in men with lower urinary tract symptoms: The Krimpen Study

Purpose: To identify patient characteristics associated with general practitioner's (GP) initial treatment decision in men with lower urinary tract symptoms (LUTS) and to test the hypothesis that a different coping style of patients results in different GP behaviour regarding treatment. Materials and methods: A longitudinal, population-based study with a follow-up period of 6.5 years was conducted among 1688 men aged 50-78 years old. Data were collected on quality of life, symptom severity based on the International prostate symptom score (IPSS) and coping. Information on primary care seeking and GP's initial management during 2 years of follow-up of all participants was collected from the general practitioners record. Results: Data were obtained of 68 men, without a history of LUTS, who had a first GP visit for LUTS during the study period. In 54.4% of the cases the GP prescribed medication, independent of symptom severity. In the group of men with a bad disease-specific QOL those with a high passive-reaction-pattern were treated less frequently than those with a low passive-reaction-pattern. Conclusion: Findings from this quantitative study are consistent with the hypothesis that different coping styles of patients may result in different GP behaviour regarding treatment. The use of the coping style passive-reaction-pattern has a large influence on GP's initial management in men with LUTS.

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