Introduction: In addition to safety and efficacy, patient satisfaction with treatment is potentially a key factor in maintaining therapy adherence. Testosterone replacement therapy (TRT) is provided using a variety of products with different features and routes of administration. These differing product characteristics may impact on patient satisfaction and adherence with a concomitant impact on well-being and health-related quality of life. The aim of this study was to explore patient satisfaction with TRT and the underlying factors.
Methods: A pragmatic literature search was carried out to identify studies on TRT for men with testosterone deficiency reporting patient satisfaction. The search was conducted in MEDLINE, and the Cochrane databases (Systematic Reviews, Central Register of Controlled Trials). The search was restricted to adult men (aged >18) with a primary diagnosis of hypogonadism/testosterone deficiency.
Results: The searches identified 682 records. Following deduplication, 397 records were assessed for relevance of which 53 were eligible for full review. A final total of eight articles was included. The results in terms of patient satisfaction were highly varied. Two studies noted no differences in patient satisfaction between injections and gels, or between those two modalities and implants. Patients were more satisfied with their current compared to previous (unspecified) TRT (two studies), as well as newer gel formulations (two studies). The factors underlying patient satisfaction included doctors recommendation, ease of use, efficacy, symptom improvement and convenience.
Conclusion: There is a significant degree of heterogeneity in patient satisfaction with TRT, which appears largely due to factors that are specific to the chosen TRT and individual patient preferences. Further work is required to determine whether specific features of TRT are instrumental in patient satisfaction. The results of this study should help inform patient interactions with their healthcare providers regarding the choice of TRT.