Grammar Clarification: "Despite" vs "In Spite Of"
Both "despite medical therapy with Flomax" and "in spite of medical therapy with Flomax" are grammatically correct and completely interchangeable—they mean exactly the same thing. These phrases indicate that symptoms persist or intervention is needed even though the patient is taking tamsulosin (Flomax).
Preferred Usage in Medical Documentation
"Despite medical therapy with Flomax" is the preferred phrasing for the following reasons:
- More concise: "Despite" is a single word versus the three-word phrase "in spite of" 1
- More formal: Medical literature and guidelines predominantly use "despite" in professional writing 2, 1
- Clearer documentation: The shorter phrase reduces ambiguity in medical records when documenting treatment failure or need for escalation 1
Clinical Context: When This Phrase Applies
This phrasing is clinically relevant when documenting:
- Persistent symptoms: When a patient continues to have bothersome lower urinary tract symptoms (LUTS) after adequate trial of tamsulosin 0.4 mg daily for 2-4 weeks 3
- Need for dose escalation: Before increasing to tamsulosin 0.8 mg daily 3
- Consideration of alternative therapy: When adding a 5-alpha reductase inhibitor (finasteride or dutasteride) for patients with enlarged prostates 1
- Surgical referral: When symptoms warrant consideration of transurethral resection of the prostate (TURP) or other invasive interventions 2, 1
Common Documentation Pitfall
Avoid using either phrase prematurely—ensure the patient has received an adequate trial (2-4 weeks minimum at 0.4 mg daily, taken 30 minutes after the same meal each day) before documenting treatment failure 3. Inadequate dosing or poor adherence should not be characterized as failure "despite" therapy 1.