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

Przydacz, Mikołaj; Campeau, Lysanne; Walter, Jens-Erik; Corcos, Jacques

doi:10.5489/cuaj.5032

Cited by 5 publications

(4 citation statements)

References 28 publications

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“…According to Basra et al, 16 no recommendations for the treatment duration for OAB have been published, and the lack of understanding of the natural history of OAB makes it difficult to provide a definite recommendation regarding the optimum therapy duration required. More recently, Przydacz et al 18 also stated that no consensus has been reached on the optimal duration of OAB treatment and that the resolution of bothersome symptoms has been considered as one of the most common reasons for treatment termination and may be achieved in more than one‐third of OAB cases. They conducted a questionnaire survey to determine the practice patterns of urologists and gynecologists on the OAB pharmacotherapy duration.…”

Section: Discussionmentioning

confidence: 99%

Overactive bladder medication: Persistence, drug switching, and reinitiation

Soda

Tashiro

Koike

et al. 2020

Neurourology and Urodynamics

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Aim: To assess real-world treatment profiles, including the time to and reasons for discontinuation or drug switching, treatment reinitiation, and postdiscontinuation follow-up in patients receiving antimuscarinics or ß3-agonists for overactive bladder (OAB) through a retrospective chart review. Methods: We retrospectively reviewed medical charts of 777 patients, aged ≥18 years, who underwent antimuscarinic or ß3-agonist therapy at our hospital. Data on patient's age, sex, chief complaint, and OAB symptom score at therapy initiation were collected. Treatment persistence was assessed with respect to the median time to discontinuation and the persistence rate at 12 months. Results: Older patients, male patients, and those with more severe urgency symptoms were more likely to show treatment persistence with OAB medications. Treatment persistence with mirabegron was significantly longer than that with antimuscarinics when administered as either the first-or second-line medication. Multivariate analyses showed that urgency severity and use of mirabegron were independently associated with better persistence (p = .026 and p = .018, respectively). Out of 583 patients who discontinued medication, 344 continued with the visit schedule, and the reinitiation rate of the OAB medication was 19% at a median follow-up of 24 months. Conclusion: Although the persistence rates for OAB medications improved with the introduction of mirabegron, most patients still discontinued the medication therapy within 1 year. The treatment strategies for patients with mild symptoms and those who are resistant to medication can still be improved. Tailored individualized treatments that avoid excessive reliance on pharmacotherapy would be key to further improve treatment outcomes in OAB patients.

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Section: Discussionmentioning

confidence: 99%

Overactive bladder medication: Persistence, drug switching, and reinitiation

Soda

Tashiro

Koike

et al. 2020

Neurourology and Urodynamics

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“…This observation may be explained in two different ways. Whereas treatment for LUTS in men typically includes alpha-blockers or 5-alpha-reductase inhibitors with mild side effect profiles, treatment of LUTS in women often includes anticholinergics, with significant dropouts because of adverse events [ 29 ]. Alternatively, until now, public urological campaigns in Poland have been focused mainly on men, and women might be inadequately targeted.…”

Section: Discussionmentioning

confidence: 99%

Relationship between Lower Urinary Tract Symptoms and Treatment-Related Behavior in an Eastern European Country: Findings from the LUTS POLAND Study

Przydacz

Dudek

Gołąbek

et al. 2021

IJERPH

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Background: The aim of this study was to investigate the effect of lower urinary tract symptoms (LUTS) on behavior related to treatment of Polish adults aged ≥ 40 years. Methods: We conducted a computer-assisted telephone survey with a study sample stratified by age, sex, and place of residence (type, size, urban versus rural) reflecting the entire Polish population. Participants rated the frequency and symptom-specific bother of individual LUTS and their effects on seeking and receiving treatment, treatment satisfaction, and treatment continuation. We adjusted multiple logistic regression models to analyze the simultaneous effects of predictor variables on each dependent variable. Results: Overall, 6005 participants completed the interview. One third (29.6–33.5%) of participants with LUTS were seeking treatment, and 24.0–26.4% received treatment. There was no difference in treatment seeking and receiving between urban and rural areas. Whereas storage and voiding symptoms were significantly related to treatment seeking by both men and women, treatment receiving correlated only with voiding symptoms in men and only with storage symptoms in women. Most respondents who received treatment were satisfied; treatment dissatisfaction was related to the presence of storage symptoms in both men and women. Only 50% of all participants continued their treatment; discontinuation of treatment was statistically more prevalent for women than for men. Conclusion: This investigation, the first population-representative study performed in Eastern Europe, revealed a low frequency of seeking treatment for LUTS. In addition, symptoms that inclined participants to seek treatment might not have been adequately addressed by the treatment they received. We also found a relatively high rate of treatment discontinuation. Clearly, there is a need for both improved patient education about LUTS treatment and a need for increased clinician awareness of the coexistence of different symptoms in men and women plus proactive evaluation by physicians for all types of LUTS and associated bother.

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“…A Canadian group sought to investigate the practices utilized by urologists and gynecologists regarding the treatment of OAB (38). In the survey, the study found that 52% versus 45% of urologists, and gynecologists stated that its treatment should be time defined rather than lifelong.…”

Section: Physician Perspectivementioning

confidence: 99%

The Pharmacotherapy Time-to-Effect of Overactive Bladder Medications and Treatment Duration

Przydacz¹,

Chłosta²

2020

Acta Poloniae Pharmaceutica - Drug Research

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For Overactive Bladder (OAB) treatment, pharmacotherapy is currently deemed as a second option. However, in the current publications related to OAB, there is a significant research gap concerning the time-toeffect and duration of OAB pharmacotherapy. Such data is vital for effective and successful treatment of OAB, and hence, the study aimed to find information in this gap to assist healthcare providers in their daily activities in treating OAB. The study utilized the Web of Science databases, MEDLINE, Cochrane Library, and PubMed Central to find and collect the highest number of data. The literature review showed limited research concerning the time-to-effect and optimal treatment duration for OAB. However, based on the available data, it can be stated that the time-to-effect of OAB pharmacotherapy would be after seven days of the initial treatment. Besides, patients with OAB can be effectively treated for 6 to 12 months before the medications are stopped but patients need to be carefully educated about a risk of symptom reoccurrence and retreatment. Those who require further medications or have a higher risk of symptom reoccurrence may need lifetime pharmacotherapy or different treatment approaches. Further research is needed to focus on the time-to-effect during the first week of medication to accurately determine when first symptom reduction occurs, and carefully follow up for patients that show a positive response after the treatment has been ceased.

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

Cited by 5 publications

References 28 publications

Overactive bladder medication: Persistence, drug switching, and reinitiation

Overactive bladder medication: Persistence, drug switching, and reinitiation

Relationship between Lower Urinary Tract Symptoms and Treatment-Related Behavior in an Eastern European Country: Findings from the LUTS POLAND Study

The Pharmacotherapy Time-to-Effect of Overactive Bladder Medications and Treatment Duration

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