Patients with Overactive Bladder Are Not Receiving Pharmacologic Therapy
Cincinnati—A new retrospective study of patients with overactive bladder (OAB) found that only a small percentage of those in the study population received pharmacologic therapy to treat the disorder. The findings from this study were reported during a poster session at the AMCP meeting. The poster was titled A Retrospective Review Evaluating Diagnosis and Management Patterns in Overactive Bladder.
OAB is a prevalent condition affecting about 1 in 6 adults in the United States; however, according to the authors of this recent study, despite the availability of behavioral and pharmacological interventions to try to improve symptoms or quality of life, only about half of patients who are bothered by symptoms discuss their condition with their doctor.
In this study, researchers hoped to learn more about the prevalence of OAB, treatment patterns, and adherence rates of pharmacologic therapy by examining medical and pharmacy claims data from UPMC Health Plan, a regional health plan.
Researchers evaluated data from 211,555 members of the health plan who had been continuously enrolled from January 2009 to December 2011 and who were part of the company's commercial (n=142,946), Medicaid (n=21,251), Medicare (n=37,381), or special needs (n=9,577) product lines.
To be included in the study, participants had to have a documented diagnosis of OAB in their medical claims history and be between 18 and 89 years of age.
The primary outcomes of the study were prevalence of an OAB diagnosis and non-pharmacologic and pharmacologic prescribing patterns. Researchers also identified several secondary outcomes including medication adherence and persistence rates, possible correlations between prescribing patterns and adherence behaviors and demographics, and trend comparisons to national data.
Researchers identified non-pharmacologic treatment by looking for claims for biofeedback, bladder augmentation, collagen or cystoscopy injections, nerve stimulation, physical therapy, prostatectomy, sling surgery, urodynamic studies, or bladder or transrectal ultrasonography.
They identified those patients receiving pharmacologic care by identifying pharmacy claims for α-1 antagonists, micturition agents, neuromuscular blocking agents, urinary antispasmodics, or vaginal estrogens.
Researchers identified 43,380 people within the study population who had OAB. These patients were primarily female (64.2%) and were ≥65 years of age (67.5%).
The overall prevalence of OAB in the UPMC Health Plan was just over 20%, making it higher than the national prevalence rate of 16%.
After conducting the retrospective analysis, researchers found that 27% of the members were utilizing pharmacologic therapy for OAB, while 42% utilized non-pharmacologic therapy options. Of those using pharmacologic therapy, the most common agents being used were urinary antispasmodics (46%), followed by micturition agents (39%), vaginal estrogens (18%), neuromuscular blockers (18%), and a-1 adrenergic antagonists (13%).
When researchers examined therapy trends based on demographic characteristics, they found that being male, ≥65 years of age, or of the Medicare or Special Needs Plan product line correlated with the use of non-pharmacologic therapy (P<.05). The use of pharmacologic therapy correlated with being female, <65 years of age, or of the Medicare and Special Needs Plan product lines (P<.05).
