Literature DB >> 27032397

Limitations of anticholinergic cycling in patients with overactive bladder (OAB) with urinary incontinence (UI): results from the CONsequences of Treatment Refractory Overactive bLadder (CONTROL) study.

Michael B Chancellor1, Alon Yehoshua2, Catherine Waweru3, Denise Globe4, I-Ning Cheng5, Karen L Campbell2, Manher Joshi2, Riya Pulicharam6.   

Abstract

PURPOSE: To describe treatment patterns and outcomes in wet-overactive bladder (OAB) patients treated with anticholinergics.
METHODS: This study was a retrospective claims analysis linked to a one-time patient survey of members of a regional medical group located in California. Participants met the following criteria: received anticholinergic therapy between January 2008 and May 2012, based on pharmacy claims; had a diagnosis of OAB; and reported having ≥1 urinary incontinence (UI) episode per day at the time of the survey. Outcomes included the number of anticholinergics cycled through from treatment initiation until the end of follow-up (May 31, 2013); frequency of UI episodes; and patient requests for additional help for their OAB symptoms.
RESULTS: A total of 620 patients were enrolled into the study. During the follow-up period, patients cycled through 1 to 6 unique anticholinergics; 65 % of the study population used only 1 anticholinergic, while 35 % used ≥2 anticholinergics. Patients reported experiencing an average of 3.5 UI episodes per day (3.6, 3.3, and 3.4 episodes for 1, 2, and ≥3 anticholinergics used, respectively), and over 80 % of patients requested additional help for their OAB symptoms, irrespective of how many anticholinergics were attempted.
CONCLUSION: UI symptom burden and adherence to therapy did not change as patients attempted more anticholinergic therapies. These results suggest that for patients who remain incontinent after attempting an anticholinergic, cycling on additional anticholinergics may not provide any additional benefit, resulting in sub-optimal care.

Entities:  

Keywords:  Anticholinergics; Limitations; Overactive bladder; Urinary incontinence

Mesh:

Substances:

Year:  2016        PMID: 27032397     DOI: 10.1007/s11255-016-1277-0

Source DB:  PubMed          Journal:  Int Urol Nephrol        ISSN: 0301-1623            Impact factor:   2.370


  11 in total

1.  Persistence and adherence of medications for chronic overactive bladder/urinary incontinence in the california medicaid program.

Authors:  Yanni F Yu; Michael B Nichol; Andrew P Yu; Jeonghoon Ahn
Journal:  Value Health       Date:  2005 Jul-Aug       Impact factor: 5.725

2.  Persistence with overactive bladder pharmacotherapy in a Medicaid population.

Authors:  Fadia T Shaya; Steven Blume; Anna Gu; Teresa Zyczynski; Zhanna Jumadilova
Journal:  Am J Manag Care       Date:  2005-07       Impact factor: 2.229

3.  Long-term patterns of use and treatment failure with anticholinergic agents for overactive bladder.

Authors:  Michael B Chancellor; Kristen Migliaccio-Walle; Thomas J Bramley; Sham L Chaudhari; Catherine Corbell; Denise Globe
Journal:  Clin Ther       Date:  2013-10-03       Impact factor: 3.393

Review 4.  An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for female pelvic floor dysfunction.

Authors:  Bernard T Haylen; Dirk de Ridder; Robert M Freeman; Steven E Swift; Bary Berghmans; Joseph Lee; Ash Monga; Eckhard Petri; Diaa E Rizk; Peter K Sand; Gabriel N Schaer
Journal:  Neurourol Urodyn       Date:  2010       Impact factor: 2.696

5.  Pharmacotherapy adherence and costs versus nonpharmacologic management in overactive bladder.

Authors:  Elise M Pelletier; Vasudha Vats; J Quentin Clemens
Journal:  Am J Manag Care       Date:  2009-03       Impact factor: 2.229

6.  Persistence, adherence, and switch rates among extended-release and immediate-release overactive bladder medications in a regional managed care plan.

Authors:  Anna O D'Souza; Michael J Smith; Lesley-Ann Miller; Joseph Doyle; Rinat Ariely
Journal:  J Manag Care Pharm       Date:  2008-04

7.  Discontinuation rates of anticholinergic medications used for the treatment of lower urinary tract symptoms.

Authors:  Manish Gopal; Kevin Haynes; Scarlett L Bellamy; Lily A Arya
Journal:  Obstet Gynecol       Date:  2008-12       Impact factor: 7.661

8.  Prevalence and burden of overactive bladder in the United States.

Authors:  W F Stewart; J B Van Rooyen; G W Cundiff; P Abrams; A R Herzog; R Corey; T L Hunt; A J Wein
Journal:  World J Urol       Date:  2002-11-15       Impact factor: 4.226

9.  Predictors of medication adherence and associated health care costs in an older population with overactive bladder syndrome: a longitudinal cohort study.

Authors:  Rajesh Balkrishnan; Monali J Bhosle; Fabian T Camacho; Roger T Anderson
Journal:  J Urol       Date:  2006-03       Impact factor: 7.450

Review 10.  Long-term adherence to antimuscarinic therapy in everyday practice: a systematic review.

Authors:  Paul W Veenboer; J L H Ruud Bosch
Journal:  J Urol       Date:  2013-10-16       Impact factor: 7.450

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  6 in total

1.  Incontinence: The dilemma with comparing efficacy of OAB treatments.

Authors:  Arun Sahai; Sachin Malde
Journal:  Nat Rev Urol       Date:  2017-05-16       Impact factor: 14.432

Review 2.  Anticholinergic Drugs for Overactive Bladder in Frail Older Patients: The Case Against.

Authors:  Henry J Woodford
Journal:  Drugs Aging       Date:  2018-09       Impact factor: 3.923

3.  Real-life clinical practice of onabotulinum toxin A intravesical injections for overactive bladder wet: an Italian consensus statement.

Authors:  Antonella Giannantoni; Antonio Carbone; Roberto Carone; Mauro Cervigni; Giulio Del Popolo; Enrico Finazzi Agrò; Gianfranco Giocoli Nacci; Giovanni Palleschi; Stefano Salvatore; Michele Spinelli; Andrea Tubaro
Journal:  World J Urol       Date:  2016-05-26       Impact factor: 4.226

Review 4.  Which drugs are best for overactive bladder? From patients' expectations to physicians' decisions.

Authors:  Ian Milsom; Adrian Wagg; Matthias Oelke; Christopher Chapple
Journal:  Int J Clin Pract       Date:  2020-12-11       Impact factor: 2.503

5.  What are the chances of improvement or cure from overactive bladder? A pooled responder analysis of efficacy and treatment emergent adverse events following treatment with fesoterodine.

Authors:  Adrian S Wagg; Sender Herschorn; Martin Carlsson; Mireille Fernet; Matthias Oelke
Journal:  Neurourol Urodyn       Date:  2021-05-26       Impact factor: 2.367

Review 6.  Pharmacology of the lower urinary tract: update on LUTS treatment.

Authors:  Pedro Abreu-Mendes; João Silva; Francisco Cruz
Journal:  Ther Adv Urol       Date:  2020-05-13
  6 in total

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