{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T14:16:42Z","timestamp":1787926602270,"version":"build-2784847793"},"reference-count":26,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Am J Mens Health"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:p>\n                    Testosterone deficiency syndrome in men is common and associated with substantial symptom burden and reduced quality of life. Although testosterone replacement therapy (TRT) can improve patient-reported outcomes, real-world benefit depends on consistent adherence and structured follow-up. In outpatient settings, adherence and symptoms are rarely assessed using validated patient-reported outcome measures (PROMs), limiting treatment monitoring. This project implemented a structured PROM workflow including the Morisky Medication Adherence Scale (MMAS-8), Aging Males\u2019 Symptoms (AMS) scale, and Short Form-8 Health Survey (SF-8\u2122) to improve testosterone therapy adherence, symptom and quality of life monitoring in an outpatient men\u2019s health clinic. A quality improvement initiative was conducted among adult men receiving TRT. Participants completed validated PROMs at baseline, 6 weeks, and 12 weeks. Primary outcomes included adherence (MMAS-8) and PROM completion; secondary outcomes included follow-up attendance, quality of life (SF-8 PCS\/MCS), symptom severity (AMS total\/domains), and objective measures (testosterone and BMI). Fifty-four participants enrolled, and 50 completed 12-week follow-up (92.6% retention). MMAS-8 scores improved from baseline (\n                    <jats:italic toggle=\"yes\">M<\/jats:italic>\n                    = 5.26,\n                    <jats:italic toggle=\"yes\">SD<\/jats:italic>\n                    = 2.32) to 6 weeks (\n                    <jats:italic toggle=\"yes\">M<\/jats:italic>\n                    = 6.29,\n                    <jats:italic toggle=\"yes\">SD<\/jats:italic>\n                    = 1.52) and 12 weeks (\n                    <jats:italic toggle=\"yes\">M<\/jats:italic>\n                    = 7.19,\n                    <jats:italic toggle=\"yes\">SD<\/jats:italic>\n                    = 0.89) (\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    &lt; .001). AMS total scores decreased over time (\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    = .006), with improvements across psychological (\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    = .032), somatic (\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    = .002), and sexual domains (\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    = .011). Testosterone levels increased (\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    = .014), while BMI remained unchanged. Integrating PROMs into routine TRT follow-up was feasible and associated with improved adherence, high engagement, and meaningful improvements in patient-reported symptoms and quality of life.\n                  <\/jats:p>","DOI":"10.1177\/15579883261466002","type":"journal-article","created":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T15:44:36Z","timestamp":1787672676000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Improving Testosterone Therapy Adherence and Quality of Life Monitoring in Men With Hypogonadism: A Quality Improvement Project Using Patient-Reported Outcome Measures"],"prefix":"10.1177","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-6244-6790","authenticated-orcid":false,"given":"Candice","family":"Abrams","sequence":"first","affiliation":[{"name":"Duke University School of Nursing"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathryn Evans","family":"Kreider","sequence":"additional","affiliation":[{"name":"Duke University School of Nursing"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9937-8710","authenticated-orcid":false,"given":"Eleanor L.","family":"Stevenson","sequence":"additional","affiliation":[{"name":"Duke University School of Nursing"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie A.","family":"Thompson","sequence":"additional","affiliation":[{"name":"Duke University School of Nursing"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,8,25]]},"reference":[{"key":"e_1_3_5_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD005470.pub3"},{"key":"e_1_3_5_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.euf.2017.10.016"},{"key":"e_1_3_5_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1611179"},{"key":"e_1_3_5_5_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMsa1616035"},{"key":"e_1_3_5_6_1","volume-title":"FDA issues class-wide labeling changes for testosterone products","author":"Center for Drug Evaluation and Research","year":"2025","unstructured":"Center for Drug Evaluation and Research. (2025, February 28). FDA issues class-wide labeling changes for testosterone products. U.S. Food and Drug Administration. https:\/\/www.fda.gov\/drugs\/drug-safety-and-availability\/fda-issues-class-wide-labeling-changes-testosterone-products"},{"key":"e_1_3_5_7_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1988.03410120089033"},{"key":"e_1_3_5_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsxm.2017.11.225"},{"key":"e_1_3_5_9_1","doi-asserted-by":"publisher","DOI":"10.1210\/clinem\/dgae085"},{"key":"e_1_3_5_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/jsm.12146"},{"issue":"1","key":"e_1_3_5_11_1","first-page":"1","article-title":"The Aging Males\u2019 Symptoms (AMS) scale: Update and compilation of international versions","volume":"1","author":"Heinemann L. A.","year":"2003","unstructured":"Heinemann L. A., Saad F., Zimmermann T., Novak A., Myon E., Badia X., Potthoff P., T\u2019Sjoen G., P\u00f6ll\u00e4nen P., Goncharow N. P., Kim S., Giroudet C. (2003). The Aging Males\u2019 Symptoms (AMS) scale: Update and compilation of international versions. Health and Quality of Life Outcomes, 1(1), 1\u201315. https:\/\/doi.org\/10.1186\/1477-7525-1-15","journal-title":"Health and Quality of Life Outcomes"},{"key":"e_1_3_5_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2666-7568(23)00169-1"},{"key":"e_1_3_5_13_1","doi-asserted-by":"publisher","DOI":"10.5534\/wjmh.200174"},{"key":"e_1_3_5_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaip.2024.08.030"},{"issue":"1","key":"e_1_3_5_15_1","first-page":"59","article-title":"New medication adherence scale versus pharmacy fill rates in seniors with hypertension","volume":"15","author":"Krousel-Wood M.","year":"2009","unstructured":"Krousel-Wood M., Islam T., Webber L. S., Re R. N., Morisky D. E., Muntener P. (2009). New medication adherence scale versus pharmacy fill rates in seniors with hypertension. The American Journal of Managed Care, 15(1), 59\u201366. https:\/\/pubmed.ncbi.nlm.nih.gov\/19146365\/","journal-title":"The American Journal of Managed Care"},{"key":"e_1_3_5_16_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2215025"},{"key":"e_1_3_5_17_1","doi-asserted-by":"publisher","DOI":"10.1080\/13685538.2021.1962840"},{"key":"e_1_3_5_18_1","doi-asserted-by":"publisher","DOI":"10.1089\/andro.2022.0021"},{"key":"e_1_3_5_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.juro.2018.03.115"},{"key":"e_1_3_5_20_1","doi-asserted-by":"publisher","DOI":"10.1210\/clinem\/dgad484"},{"key":"e_1_3_5_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsxm.2017.07.004"},{"key":"e_1_3_5_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2006.03.012"},{"key":"e_1_3_5_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ecl.2021.11.016"},{"key":"e_1_3_5_24_1","doi-asserted-by":"publisher","DOI":"10.2196\/27180"},{"key":"e_1_3_5_25_1","doi-asserted-by":"publisher","DOI":"10.2147\/PPA.S382885"},{"key":"e_1_3_5_26_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13012-019-0892-4"},{"key":"e_1_3_5_27_1","volume-title":"How to score and interpret single-item health status measures: A manual for users of the SF-8\u2122 Health Survey","author":"Ware J. E.","year":"2001","unstructured":"Ware J. E., Kosinski M., Dewey J. E., Gandek B. (2001). How to score and interpret single-item health status measures: A manual for users of the SF-8\u2122 Health Survey. QualityMetric Incorporated."}],"container-title":["American Journal of Men's Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/15579883261466002","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/15579883261466002","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/15579883261466002","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T13:17:09Z","timestamp":1787923029000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/15579883261466002"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7]]},"references-count":26,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2026,7]]}},"alternative-id":["10.1177\/15579883261466002"],"URL":"https:\/\/doi.org\/10.1177\/15579883261466002","relation":{},"ISSN":["1557-9883","1557-9891"],"issn-type":[{"value":"1557-9883","type":"print"},{"value":"1557-9891","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7]]},"article-number":"15579883261466002"}}