Journal article
Practice Patterns for Women With Overactive Bladder Syndrome: Time Between Medications and Third-Line Treatments
Female pelvic medicine & reconstructive surgery, v 26(7), pp 431-436
01 Jul 2020
PMID: 32265405
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Objective The aims of this study are to determine how long it takes female patients with overactive bladder (OAB) to receive third-line treatment after starting OAB medications and identify factors associated with increased time. Methods This was a retrospective observational cohort study of adult female patients with OAB who received third-line treatment between 2013 and 2015 using insurance claims databases. Primary outcome was time between first OAB medication and first third-line treatment. Additional variables were patient demographics, diagnostic tests, and medical comorbidities. Results Of 3232 patients included in this study, 48.8% underwent sacral neuromodulation, 31.6% percutaneous tibial nerve stimulation, and 23% intradetrusor onabotulinumtoxin A injections. Twenty-one percent of patients filled medication prescriptions for 3 or more antimuscarinic medications, 30.4% took mirabegron, and 32.3% had advanced diagnostic tests suggestive of a specialist evaluation prior to starting medications. Median time to third-line treatment was 37.7 (interquartile range, 14.9, 16.3) months. Adjusted linear regression model revealed 2 predominant predictors of time to third-line treatments: each antimuscarinic medication trial was associated with 5.3 (95% confidence interval, 4.4-6.3) more months before third-line treatment (P < 0.001), and advanced diagnostic evaluations prior to starting medications were associated with 28.2 (95% confidence interval, 21-35) fewer months before third-line treatment (P < 0.001). Conclusions Women with OAB who undergo third-line therapy do so on average more than 3 years after starting medications. Time to third-line treatment is largely driven by the number of antimuscarinic medications tried and timing of diagnostic evaluation by a specialist. Based on these results, we suggest providers consider limiting antimuscarinic trials to 2 medications prior to moving on to other treatment options.
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Details
- Title
- Practice Patterns for Women With Overactive Bladder Syndrome: Time Between Medications and Third-Line Treatments
- Creators
- Anna C. Kirby - University of WashingtonSungchul Park - Drexel UniversitySara B. Cook - University of WashingtonKatherine Odem-Davis - Seattle Children's Research InstituteJohn L. Gore - University of WashingtonErika M. Wolff - University of Washington
- Publication Details
- Female pelvic medicine & reconstructive surgery, v 26(7), pp 431-436
- Publisher
- Lippincott Williams & Wilkins
- Number of pages
- 6
- Grant note
- Department of Obstetrics and Gynecology at the University of Washington
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Health Management and Policy
- Web of Science ID
- WOS:000548840700005
- Scopus ID
- 2-s2.0-85086105949
- Other Identifier
- 991019167708004721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Obstetrics & Gynecology