Factors affecting medication discontinuation in patients with overactive bladder symptoms

Abstract

ObjectiveTo find out the factors affecting medication discontinuation in patients with overactive bladder (OAB) symptoms.MethodsThe clinical data of 125 patients with OAB symptoms who had taken antimuscarinics and behavioral therapy were retrospectively reviewed. Antimuscarinics related outcomes were evaluated by an independent observer with telephone interview. All patients were asked about duration of medication and reason of continuation or discontinuation of antimuscarinics. To determine pre-treatment factors predicting self-report discontinuation of antimuscarinics, variables of only those with P-values <0.25 on the univariate analysis were included in the Cox proportional hazard modeling.ResultsMean follow-up was 39.6 months and the proportion of discontinuation of antimuscarinics was 60.0% (75/125). The mean duration of medication was 21.2 months in the continuation group and 3.3 months in the discontinuation group. The reasons of discontinuation of antimuscarinics were improved OAB symptoms (46.7%), tolerable OAB symptoms (33.3%), no change of OAB symptoms (1.3%), side-effects (8.0%) and no desire to take long-term medication (10.7%). The variables affecting remaining cumulative probability of antimuscarinics were age, history of anti-incontinence surgery or vaginal surgery, and having stress predominant urinary incontinence on urodynamic study.ConclusionThe lower rate of cumulative continuation of antimuscarinics encourages us to give a more detailed counseling and education to the patients with OAB symptoms before prescription. And explorations about newer agent and non-pharmacologic treatment with good efficacy and lower side-effects are needed.

How long do we have to treat overactive bladder syndrome? A questionnaire survey of Canadian urologists and gynecologists

“…The resolution of bothering symptoms has been given as one of the most common reasons for termination of treatment and may be achieved in more than one-third of OAB cases. [11][12][13][14][15] Other common reasons for medication discontinuation are adverse effects and/or failure of expected clinical outcome. There is no consensus regarding the optimal duration of OAB treatment as, in the vast majority of available clinical trials, time periods of drug administration have been reported to range from 2 weeks to 12 months.…”

Vaistų, Vartojamų Dirgliosios Šlapimo Pūslės Sindromo Gydymui, Efektyvumo Palyginimas

“…R. Aniulienės su bendraautoriais darbe ŠN besiskundžiančių moterų amžius buvo 63,52±11,74 metai [16]. Užsienio šaltiniuose DŠP sergančių pacienčių amžius buvo 57,5±11,25 metai [17].…”

“…Kitų autorių atliktuose tyrimuose šalutinių patologijų dažnis nuo šiame tyrime nagrinėtų patologijų dažnio skyrėsi: arterinės hipertenzijos dažnis svyravo nuo 32% iki 77%, 2 tipo cukrinio diabeto nuo 15,2% iki 41% [16,17,18]. Tuo tarpu mūsų atliktame tyrime arterine hipertenzija bei cukriniu diabetu atitinkamai sirgo 49,1% ir 10,1% pacienčių.…”

“…Atitinkamai mūsų atliktame tyrime nutukimo dažnis buvo dvigubai didesnis -20,6%, o TVT-O operacijų dvigubai mažesnis -13,8%. Shim EJ ir kitų 2015 metais atliktame tyrime histerektomijos dažnis (25,6%) žymiai nesiskyrė nuo šiame tyrime gauto dažnio (24,8%) [17].…”

“…E.J. Shim ir bendraautorių tyrime šių vaistų veiksmingumas vertintas po daugiau nei trejų metų, tačiau geras gydymo efektas pasiektas panašiai daliai pacienčių (46,7%) [21]. Tuo tarpu mūsų atliktame tyrime gydymo trukmė nebuvo vertinta, vis dėlto geras gydymo efektas tarp amžiaus grupių (≤65 m. ir >65 m.), statistiškai reikšmingai nesiskyrė ir siekė net 79%.…”