Ravishankar Jayadevappa1,2,3,4,5, Sumedha Chhatre5, Diane K Newman3, Jerome Sanford Schwartz1, Alan J Wein3. 1. Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania. 2. Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, Pennsylvania. 3. Division of Urology, Department of Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania. 4. Corporal Michael J. Crescenz VAMC, Philadelphia, Pennsylvania. 5. Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
Abstract
AIMS: To analyze the risk of falls associated with Overactive bladder (OAB), and the effects of OAB treatment on falls among older adult Medicare fee-for-service enrollees. METHODS: Population based retrospective longitudinal cohort design study using 5% Medicare claims between 2006 and 2010. Patients with a diagnosis of OAB (ICD 9: 596.51); Urinary Incontinence (ICD 9: 788.3); Urinary incontinence, unspecified (ICD 9: 788.30); Urge incontinence (ICD 9: 788.31); Mixed incontinence (male, female) (ICD 9: 788.33); Urinary frequency (ICD 9: 788.41); Nocturia (ICD 9: 788.43); or Urgency of urination (ICD 9: 788.63) were identified and followed retrospectively for 2 years. Falls was the main outcome of the study. Using logistic regressions, we analyzed the association between OAB and falls; and the protective effect of OAB treatment on falls. Propensity score and instrumental variable were used to minimize bias. RESULTS: We identified 33 631 Medicare enrollees (mean age = 77.8 years, sd = 7.6) with OAB. Higher proportion of OAB patients had falls, compared to those without OAB (11% vs 7%, P < 0.001). Diagnosis of OAB was associated with higher odds of falls (OR = 1.59; 95% CI = 1.53, 1.65) compared to those without OAB. Fourteen percent of OAB patients received OAB treatment. Treatment for OAB was associated with lower odds of falls (OR = 0.88; 95% CI = 0.80, 0.98) compared to those OAB patients who were not treated. CONCLUSIONS: Older adults with OAB experience increased risk of falls. Treatment for OAB may reduce this risk. These findings emphasize the need to effectively identify and treat OAB in older adults.
AIMS: To analyze the risk of falls associated with Overactive bladder (OAB), and the effects of OAB treatment on falls among older adult Medicare fee-for-service enrollees. METHODS: Population based retrospective longitudinal cohort design study using 5% Medicare claims between 2006 and 2010. Patients with a diagnosis of OAB (ICD 9: 596.51); Urinary Incontinence (ICD 9: 788.3); Urinary incontinence, unspecified (ICD 9: 788.30); Urge incontinence (ICD 9: 788.31); Mixed incontinence (male, female) (ICD 9: 788.33); Urinary frequency (ICD 9: 788.41); Nocturia (ICD 9: 788.43); or Urgency of urination (ICD 9: 788.63) were identified and followed retrospectively for 2 years. Falls was the main outcome of the study. Using logistic regressions, we analyzed the association between OAB and falls; and the protective effect of OAB treatment on falls. Propensity score and instrumental variable were used to minimize bias. RESULTS: We identified 33 631 Medicare enrollees (mean age = 77.8 years, sd = 7.6) with OAB. Higher proportion of OABpatients had falls, compared to those without OAB (11% vs 7%, P < 0.001). Diagnosis of OAB was associated with higher odds of falls (OR = 1.59; 95% CI = 1.53, 1.65) compared to those without OAB. Fourteen percent of OABpatients received OAB treatment. Treatment for OAB was associated with lower odds of falls (OR = 0.88; 95% CI = 0.80, 0.98) compared to those OABpatients who were not treated. CONCLUSIONS: Older adults with OAB experience increased risk of falls. Treatment for OAB may reduce this risk. These findings emphasize the need to effectively identify and treat OAB in older adults.
Authors: Shelagh M Szabo; Katherine Gooch; Carol Schermer; David Walker; G Lozano-Ortega; Basia Rogula; Alison Deighton; Edward Vonesh; Noll Campbell Journal: BMJ Open Date: 2019-05-05 Impact factor: 2.692
Authors: Greta Lozano-Ortega; Carol R Schermer; David R Walker; Shelagh M Szabo; Basia Rogula; Alison M Deighton; Katherine L Gooch; Noll L Campbell Journal: Pharmacoecon Open Date: 2021-03