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£1.5 million study aims to empower GPs to make faster and more accurate diagnoses for men with Lower Urinary Tract Symptoms

26 March 2018

Primus study

Many men experience Lower Urinary Tract Symptoms (LUTS) as they get older. Problems include passing urine more frequently than usual which can interrupt sleep, or experiencing a poor flow rate. Although GPs follow certain processes when considering serious conditions or cancer, there is currently no single effective way to identify and treat LUTS in primary care. Men are increasingly referred to urology specialists who often recommend treatments that could have been initiated in primary care (care provided by GPs, before being referred to a hospital), if GPs had access to better diagnostic tools.

Access to simple, accurate tests, diagnostic protocols and decision tools are needed to facilitate patient management in primary care.

The PriMUS study run by the Centre for Trials Research at Cardiff University aims to develop a clinical decision support tool based on symptoms, signs, patient characteristics and tests that can be done in primary care - predominantly following National Institute for Health and Care Excellence (NICE) guidelines. These features and tests will be compared to the current ’gold standard’ test used to predict the cause of LUTS in secondary care: urodynamics. Urodynamics involves passing catheters into the bladder and rectum in order to make precise measurements regarding bladder function. The clinical decision support tool will be a computer software programme, which will indicate likely diagnosis and recommended management options for the GP to discuss with patients.

There is a limit primary care can offer without additional information, up until now, only available in secondary care.  The development of this clinical decision support tool gives us real data to work with and enable a much more guided approach to the management of LUTS in men. The patient will benefit from faster diagnosis and management, as well as reducing the burden of secondary care referrals.

GP involved in study design expressing importance of the PriMUS study in helping GP Practices.

The PriMUS study will recruit 880 male participants across three research hubs based in Newcastle upon Tyne, Bristol and Wales. Participants will be recruited opportunistically, upon presentation with LUTS to the GP, or invited to take part in the study by screening patient notes for eligibility.

All participants will undergo a series of primary care tests and the invasive urodynamics test, within a few weeks of seeing their GP. This study has the potential to give patients early access to appropriate treatments (e.g. medication, lifestyle changes) and to reduce referrals and the pressure on secondary care urology services. Additionally, those who need urgent referral for more complex or serious conditions will benefit from reduced waiting lists.

The PriMUS Study opened for patient recruitment in general practices on 19 February 2018.

The study is funded by the NIHR Health Technology Assessment programme.

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