Assessment of treatment outcomes in patients with overactive bladder: Importance of objective and subjective measures

Long‐term benefits of darifenacin treatment for patient quality of life: Results from a 2‐year extension study

“…6 HRQoL improvement therefore represents a major goal of therapy for OAB, and is becoming increasingly recognized in the assessment of treatments for this debilitating condition. 7 With long-term control in mind, the management of OAB primarily involves bladder retraining and life-style modification including fluid intake and dietary discretion. Pharmacological treatments are often added to these behavioral therapies, most commonly with antimuscarinic agents, which can provide significant relief from OAB symptoms.…”

Overactive Bladder Disease: The Urge for Better Therapies

“…Patient-reported outcomes, assessed by subjective measures, provide an opportunity to improve one's understanding of OAB outcomes and may even help to redefine a treatment success. 25 As stated by Fairclough et al, "While we can measure a biological response, we may not be able to determine whether that response makes a noticeable difference to the patient." 26 Treatment with anti-muscarinic agents in the management of OAB typically requires at least 4 to 8 weeks of continuous therapy before the benefits of therapy are realized.…”

“…In some studies, objective end points demonstrated larger differences between treatment groups compared with subjective measures. 25 For example, a trial of oxybutynin IR in elderly patients demonstrated that patients receiving oxybutynin IR experienced statistically significant reductions in daytime micturitions during a 2-week period compared with those receiving placebo. After 6 weeks of treatment, the percentage of patients who perceived a benefit of treatment appeared to be greater in the treatment group compared with placebo group (79% vs. 55%), but the difference was not statistically significant (P = 0.09).…”

“…Furthermore, patients were asked to grade their improvement based on a 4-point ranked ordinal scale; ratings failed to demonstrate significant differences between groups at the end of the study. 25,28 In a placebo-controlled trial of tolterodine IR and oxybutynin IR, 12 weeks of treatment with tolterodine IR significantly reduced 24-hour micturitions compared with placebo. Patients receiving oxybutynin IR demonstrated statistically significantly reduced 24-hour urge UI episodes compared with placebo.…”

“…Future studies with a greater emphasis on subjective measures using instruments that have undergone validation studies, such as OAB questionnaires, are needed in order to gain a greater understanding of OAB as a chronic disease. 25 …”