Prescription drug sales have increased nearly 90% between 2000 and 2006,13 with further increases likely given the January 1, 2006 implementation of prescription drug benefits for seniors. Urologic symptoms are also on the increase;the projected burden of LUTS and incontinence will reach 60 million adults in the U.S. by the year 2025.177 The U.S. population continues to age, and urologic symptoms are strongly age-related,17, 18 as is use of prescription drugs.19 Given these broad population trends, it is important to study whether urologic problems are an iatrogenic consequence of medication use and/or polypharmacy. The research intent of this application is to use existing data from the Boston Area Community Health (BACH) Survey to fill an informational void regarding the urologic safety of commonly-used prescription and over-the-counter drugs. Data on the unintended urologic impact of prescription drugs are very sparse, although the urologic impact of drugs is recognized,20, 21 and may act through numerous biologic pathways including excretion of metabolites in the urine.31, 32, 101 The existing BACH data, comprised of over 5,500 male and female participants who are broadly diverse in terms of race/ethnicity and socioeconomic status, provide a unique, cost-effective opportunity to examine these pressing questions in a representative sample of the population. Our study will consider a broad range of urologic outcomes, including voiding-related symptoms, storage- related symptoms, urine leakage (incontinence), and erectile dysfunction which were measured in the BACH Survey using validated scales or established definitions. We will use multivariate analysis methods and population restriction to account for other risk factors for the outcomes of interest, including medical, behavioral, anthropometric and socioeconomic risk factors, as previously identified in the BACH Survey. The diverse expertise of the research team includes pharmacoepidemiology, biostatistics, and clinical urology, and the team has a demonstrated history of manuscript productivity. At least eight manuscripts are planned over the two years of the project. Our focus on 17 commonly-used prescription medications and two over-the- counter medications increases the public health relevance of the application;even results that show no increased risk of commonly-used medications will still serve the federal health goals of pharmacovigilance towards marketed medications.1 The clinical implications for the patient are the possibility of a medication switch, if particular medications are found to have a positive or negative urologic impact.
7. PROJECT NARRATIVE This study is considering whether medical problems having to do with urination or erections might be due to the types of drugs people are taking. The study looks at commonly-used prescription drugs and over-the- counter drugs and relates them to three different types of urination problems and erectile dysfunction. The data come from a survey of racially diverse men and women aged 30-79 who live in Boston, Massachusetts.
