Practice Patterns for Women With Overactive Bladder Syndrome: Time Between Medications and Third-Line Treatments.
Female Pelvic Med Reconstr Surg
; 26(7): 431-436, 2020 07.
Article
em En
| MEDLINE
| ID: mdl-32265405
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.
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Estimulação Elétrica Nervosa Transcutânea
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Antagonistas Muscarínicos
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Toxinas Botulínicas Tipo A
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Bexiga Urinária Hiperativa
Idioma:
En
Ano de publicação:
2020
Tipo de documento:
Article