How to Help Men with LUTS Help Themselves

Event Details

Meeting Summary

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Background

Lower Urinary Tract Symptoms (LUTS) in men is extremely common and usually is associated with an enlarged prostate. LUTS/BPH (benign prostatic hyperplasia) is estimated to cause more than 8 million physician office visits per year in the United States and uses considerable health care resources. Because the U.S. male population is aging, the economic burden of male LUTS is expected to increase significantly. Current treatment guidelines suggest a step-up approach. Most patients start with pharmacological treatments and suggested changes in specific behaviors, followed by some form of minimally invasive therapy if drugs and behavioral changes are not successful. It is not unusual for some patients to end with a surgical intervention. Though medical therapies such as alpha blockers, 5-alpha reductase inhibitors, PDE5 inhibitors, and anticholinergics may provide some temporary relief, adherence is a major issue either due to lack of long-term efficacy or unwanted side effects. Only one out of four patients remains on drugs after a year. In addition, patient expectations from offered treatments can be different from what the treatment achieves. Long-term patient satisfaction with minimally invasive treatments or surgical therapies also may not be optimal. There is a need to enhance the ability to engage in and maintain behavioral interventions for secondary prevention strategies in men with LUTS.

Although there are many examples in other fields of medicine, there is a paucity of literature on methods for behavioral interventions for LUTS in men and even less literature employing specific self-management skills such as goal setting, self-monitoring, and problem solving. Most of the published data on non-urologic factors that may contribute to LUTS are based on low-quality evidence. Many patients learn to cope with their symptoms themselves by adopting adaptive behaviors such as restricting fluids before sleep, precautionary voiding, and avoiding caffeinated or alcoholic beverages and certain drugs. There are a number of modifiable lifestyle factors that may impact LUTS. If taught properly, most men could learn how to manage their LUTS. A substantial proportion of men with LUTS can be educated to postpone initiation of medical or surgical therapies and associated side effects/complications.

Meeting Objectives

1. To review the evidence on various factors impacting LUTS in men
2. To discuss the knowledge base for self-management of LUTS in men
3. To identify potential intervention strategies to reduce the impact of LUTS on the quality of life of men

Organizing Committee

William Elwood
Steven Jacobsen
Steven Kaplan
Ziya Kirkali
John Kusek
Jenna Norton
Marcel Salive
Yining Xie

Registration Deadline

September 20, 2016

Agenda

September 21, 2016

7:00 a.m. – 8:00 a.m.

Registration

8:00 a.m. – 8:15 a.m.

Opening Remarks
Robert Star, M.D., NIDDK, NIH

8:15 a.m. – 8:30 a.m.

LUTS/BPH—I’m Getting Old!
Ziya Kirkali, M.D., NIDDK

Morning Session

Moderator: John Kusek, Ph.D., NIDDK

8:30 a.m. – 8:45 a.m.

What’s Wrong with Men?
Martin Miner, M.D., The Miriam Hospital

8:45 a.m. – 9:00 a.m.

Discussion

9:00 a.m. – 9:15 a.m.

Male LUTS: What We Know, What We Don’t Know,
What We Need to Know
Kevin McVary, M.D., American Urological Association

9:15 a.m. – 9:30 a.m.

Discussion

9:30 a.m. – 9:45 a.m.

Non-urologic Modifiable Factors Contributing to LUTS
Brad Erickson, M.D., University of Iowa Health Care

9:45 a.m. – 10:00 a.m.

Discussion

10:00 a.m. – 10:15 a.m.

Break

10:15 a.m. – 10:30 a.m.

LUTS in Men: Treatment and Side Effects
Michael Naslund, M.D., University of Maryland Medical Center

10:30 a.m. – 10:45 a.m.

Discussion

10:45 a.m. – 11:00 a.m.

What Is Important for the Patient?
Michael Flessner, M.D., Ph.D., NIDDK

11:00 a.m. – 11:15 a.m.

Discussion

11:15 a.m. – 11:30 a.m.

Psychosocial Processes in Self-management
William Elwood, Ph.D., Office of Behavioral and Social Sciences Research,
Office of the Director, NIH

11:30 a.m. – 11:45 a.m.

Discussion

11:45 a.m. – 12:00 p.m.

Is Self-management a Viable Option in Chronic Conditions?
Shirley M. Moore, Ph.D., R.N., FAAN, Case Western Reserve University

12:00 p.m. – 12:15 p.m.

Discussion

12:15 p.m. – 1:15 p.m.

Lunch

1:15 p.m. – 1:30 p.m.

Remarks from the Institute Director
Griffin P. Rodgers, M.D., M.A.C.P., NIDDK

Afternoon Session

Moderator: William Elwood, Ph.D., Office of Behavioral and Social Sciences Research, Office of the Director, NIH

1:30 p.m. – 1:45 p.m.

Self-management in Diabetes
Elizabeth A. Walker, Ph.D., R.N., Albert Einstein College of Medicine

1:45 p.m. – 2:00 p.m.

Discussion

2:00 p.m. – 2:15 p.m.

Arthritis: Self-management and Quality of Life
Leigh Callahan, Ph.D., The University of North Carolina at Chapel Hill

2:15 p.m. – 2:30 p.m.

Discussion

2:30 p.m. – 2:45 p.m.

Self-management for Men with LUTS—Is It Possible?
Mark Emberton, M.D., University College London Hospitals

2:45 p.m. – 3:00 p.m.

Discussion

3:00 p.m. – 3:15 p.m.

Scalability of Self-management for Men with LUTS
Steven Jacobsen, M.D., Kaiser Permanente

3:15 p.m. – 3:30 p.m.

Discussion

3:30 p.m. – 3:45 p.m.

Break

3:45 p.m. – 4:00 p.m.

A Holistic Approach to Health: Cognitive, Social, and Emotional Domains
Mary Palmer, Ph.D., R.N., FAAN, AGSF, The University of North Carolina at Chapel Hill

4:00 p.m. – 4:15 p.m.

Discussion

4:15 p.m. – 4:30 p.m.

Self-management Support Implementation
Judith Schaefer, M.P.H., Group Health Research Institute

4:30 p.m. – 4:45 p.m.

Discussion

4:45 p.m.

Adjournment (Dinner on Your Own)

September 22 2016

8:30 a.m. – 8:45 a.m.

Social Media and Technology: Impact on LUTS Management in Men
Steve Kaplan, M.D., Icahn School of Medicine at Mount Sinai

Morning Session

Moderator: Marcel Salive, M.D., M.P.H., National Institute on Aging, NIH

8:45 a.m. – 9:00 a.m.

Discussion

9:00 a.m. – 11:00 a.m.

Breakout Groups

1. What Trials Can Be Done?
   Moderator: Ziya Kirkali, M.D.
   Reporter: Steve Kaplan, M.D.
2. What Should Be the Outcomes–Health-related Quality of Life (HRQoL)?
   Moderator: John Kusek, Ph.D.
   Reporter: Steven Jacobsen, M.D.
3. How Can the Results Be Applicable to the Broader Community?
   Moderator: Jenna Norton, M.P.H.
   Reporter: Kevin McVary, M.D.

11:00 a.m. – 12:00 p.m.

Reports from the Breakout Sessions

12:00 p.m. – 12:30 p.m.

What Have We Learned?
Robert Star, M.D., NIDDK

12:30 p.m.

Adjournment