Exploring the impact of changes in neurogenic urinary incontinence frequency and condition-specific quality of life on preference-based outcomes

Hollingworth, William; Campbell, Jonathan D.; Kowalski, Jonathan W.; Ravelo, Arliene; Girod, I; Briggs, Andrew; Sullivan, Sean D.

doi:10.1007/s11136-010-9590-z

Cited by 17 publications

(7 citation statements)

References 34 publications

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“…Baseline data from a recent interventional, randomized controlled trial in SCI patients with incontinence due to NDO further suggest that the HRQoL of these patients is greatly impaired [23]. HRQoL was assessed with the Incontinence Quality of Life (I-QOL) questionnaire and SF-36 before treatment with botulinum toxin A. I-QOL is a 22-item disease-specific HRQoL questionnaire with possible scores ranging from 0 (worse HRQoL) to 100 (higher HRQoL).…”

Section: Resultsmentioning

confidence: 99%

Health-related quality of life and economic impact of urinary incontinence due to detrusor overactivity associated with a neurologic condition: a systematic review

Tapia

Khalaf

Berenson

et al. 2013

Health Qual Life Outcomes

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BackgroundPatients with neurologic diseases often have neurogenic detrusor overactivity (NDO), which can result in a loss of voluntary bladder control and uncontrollable urinary incontinence (UI).The impact of UI due to NDO on patients’ lives has not been well studied. The objective of this review was to assess the health-related quality of life (HRQoL) and economic burden in patients with urgency UI due to NDO in select countries in North America, the European Union, Asia, and Australia.MethodsSystematic literature searches and reviews of articles published in English (January 2000 to February 2011) were conducted using MEDLINE®, EMBASE®, and the Cochrane Library. Studies assessing the impact of UI on HRQoL of patients with an underlying neurologic condition of interest (i.e., multiple sclerosis, spinal cord injury, Parkinson’s disease, stroke, or spina bifida) were included. Economic studies in urgency UI also were included.ResultsOf 876 citations generated in the initial search, a total of 27 articles were deemed relevant: 16 articles presented HRQoL data and 11 articles presented information on the economic burden of UI. Humanistic studies used a range of HRQoL instruments to measure HRQoL burden, and the economic studies included different cost components to quantify the economic burden, making meaningful comparisons challenging. Despite this heterogeneity, the literature suggests that HRQoL in patients with UI due to NDO is worse than patients with UI in general or those with the same underlying neurologic condition without UI. In addition, urgency UI also results in substantial economic costs.ConclusionsIncontinent patients with underlying neurologic conditions have impaired HRQoL as well as substantial economic burden attributable to UI due to NDO. There is a need for urgency UI treatments that improve HRQoL of these patients and alleviate the economic burden of this condition.

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Section: Resultsmentioning

confidence: 99%

Health-related quality of life and economic impact of urinary incontinence due to detrusor overactivity associated with a neurologic condition: a systematic review

Tapia

Khalaf

Berenson

et al. 2013

Health Qual Life Outcomes

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“…Idiopathic detrusor overactivity (IDO) is another common type of OAB. OAB can lead to urinary incontinence and frequency and changes in urodynamic parameters including bladder capacity, compliance, and other important functions [ 5 , 6 ]. Current first-line treatment for OAB is antimuscarinic medicine [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

A systematic review and meta-analysis of effectiveness and safety of therapy for overactive bladder using botulinum toxin A at different dosages

et al. 2017

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PurposeTo assess the effectiveness and safety of botulinum toxin A (BTX-A) at different dosages for overactive bladder (OAB).Materials and MethodsThe MEDLINE, EMBASE, and Cochrane Controlled Trials Register databases were searched through November 3, 2016 to identify relevant randomized controlled trials (RCTs).ResultsEleven studies were identified in this meta-analysis. Compared with placebo, the urinary incontinence (UI) episodes per week as the primary outcomes, urodynamic parameters including maximum cystometric capacity (MCC), and maximum detrusor pressure (MDP) for neurogenic detrusor overactivity (NDO) at 6 weeks, and for idiopathic detrusor overactivity (IDO) at 36 weeks were evaluated. These and other outcomes for effectiveness of BTX-A at different dosages in two observation periods indicate that a dose greater than 50 U is significantly more effective for certain symptoms of OAB compared with placebo. However, there were no significant differences between some dosages. Compared with placebo, the outcomes of total adverse events for NDO and for IDO show that doses of 300 U and 200 U for NDO are associated with more complications.ConclusionsIn consideration that the treatments of BTX-A were with minimal, local, and manageable adverse effects, this meta-analysis demonstrates that BTX-A 200 U is recommended for management of NDO for short-term treatment for there was no significant difference from the larger dose of 300U. The short-term efficacies of BTX-A for IDO remain to be investigated.

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“…dry) states correspond to those in previously published models, which have reported such utility differences ranging from 0.19 to 0.33 [ 30 – 34 ]. Scenario analyses, based on published utility estimates of 0.66–0.78 [ 35 ] and of 0.19–0.33 (obtained from studies in patients with overactive bladder/UI) [ 30 – 34 ], increase the ICER; however, onabotulinumtoxinA + BSC still maintains its cost effectiveness in line with the NICE threshold at £20,000 per QALY gained.…”

Section: Discussionmentioning

confidence: 99%

Cost-Effectiveness Analysis of OnabotulinumtoxinA (BOTOX®) for the Management of Urinary Incontinence in Adults with Neurogenic Detrusor Overactivity: A UK Perspective

et al. 2014

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ObjectivesTo evaluate the cost effectiveness of onabotulinumtoxinA (BOTOX®, 200 units [200 U]) for the management of urinary incontinence (UI) in adults with neurogenic detrusor overactivity (NDO) due to subcervical spinal cord injury or multiple sclerosis that is not adequately managed with anticholinergic drugs (ACHDs).PerspectiveUK National Health Service (NHS) perspective.MethodsA Markov state-transition model was developed, which compared onabotulinumtoxinA + best supportive care (BSC) with BSC alone (comprising behavioural therapy and pads, alone or in combination with clean intermittent catheterization and possibly with ACHDs). Non-responders were eligible for invasive procedures. Health states were defined according to the reduction in UI episodes. Efficacy data and estimates of resource utilization were pooled from 468 patients on onabotulinumtoxinA in two phase III clinical trials. Drug costs (2013) and administration costs (NHS Reference Costs 2011–2012) were obtained from published sources. The time horizon of the model was 5 years, and costs and benefits were discounted at 3.5 %. Scenario, one-way and probabilistic sensitivity analyses (PSAs) were conducted to explore uncertainties around the assumptions.ResultsIn the base case, treatment with onabotulinumtoxinA + BSC over 5 years was associated with an increase in costs of £1,689 and an increase in quality-adjusted life-years (QALYs) of 0.4, compared with BSC alone, resulting in an incremental cost-effectiveness ratio of £3,850 per QALY gained. Sensitivity analyses showed that utility values had the greatest influence on model results. PSA suggests that onabotulinumtoxinA + BSC had a 100 % probability of being cost effective at a willingness to pay of <£20,000.ConclusionFor adult patients with NDO who are not adequately managed with ACHDs, onabotulinumtoxinA + BSC appears to be a cost-effective use of resources in the UK NHS.Electronic supplementary materialThe online version of this article (doi:10.1007/s40273-014-0245-8) contains supplementary material, which is available to authorized users.

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Exploring the impact of changes in neurogenic urinary incontinence frequency and condition-specific quality of life on preference-based outcomes

Abstract: These estimates provide preliminary data for decision analysts wishing to map neurogenic UI outcomes to preference scores.

Cited by 17 publications

References 34 publications

Health-related quality of life and economic impact of urinary incontinence due to detrusor overactivity associated with a neurologic condition: a systematic review

Health-related quality of life and economic impact of urinary incontinence due to detrusor overactivity associated with a neurologic condition: a systematic review

A systematic review and meta-analysis of effectiveness and safety of therapy for overactive bladder using botulinum toxin A at different dosages

Cost-Effectiveness Analysis of OnabotulinumtoxinA (BOTOX®) for the Management of Urinary Incontinence in Adults with Neurogenic Detrusor Overactivity: A UK Perspective

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