Incontinence Drug Utilization Patterns in Québec, Canada

Desgagné, Alain; LeLorier, Jacques

doi:10.1046/j.1524-4733.1999.26005.x

Cited by 20 publications

(16 citation statements)

References 23 publications

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“…10,11,16,18 In our study, 44.5% of patients did not refill their index prescription, suggesting that they discontinued within the first 30 days of treatment. The median days to discontinuation (non-persistency) were 31.0 overall, 33.0 for tol-ER, 34.0 for oxy-ER, 32.0 for tol-IR, and 0 for oxy-IR.…”

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confidence: 58%

“…Like this study, many previous studies assessing persistence and adherence to OAB pharmacotherapy in clinical practice [10][11][12][15][16][17][18] were also conducted using prescription claims databases. Overall persistence in our study at 1 year (13.2%) was within the range reported in the literature (8% to 29%).…”

Section: ■■ Discussionmentioning

confidence: 99%

“…Drug persistence and adherence patterns assessed for various OAB drugs in real-world settings are even worse with almost 70% to 90% of patients discontinuing treatment within 1 year. [10][11][12][13][14][15][16][17][18] The persistence drops markedly within the first 6 months and is further reduced at 1 year. In studies that have a 6-month follow-up, persistence rates of 11% to 30% have been reported, 10,11,16,18 and in studies with at least 1 year of follow-up, persistence rates range from 8% to 29%.…”

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confidence: 99%

“…[10][11][12][13][14][15][16][17][18] The persistence drops markedly within the first 6 months and is further reduced at 1 year. In studies that have a 6-month follow-up, persistence rates of 11% to 30% have been reported, 10,11,16,18 and in studies with at least 1 year of follow-up, persistence rates range from 8% to 29%. 12,13,[16][17][18] In general, oxybutynin immediate-release (oxy-IR) has the lowest persistency rate, and tolterodine extended-release (tol-ER) has the highest persistency rate.…”

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confidence: 99%

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Persistence, Adherence, and Switch Rates Among Extended-Release and Immediate-Release Overactive Bladder Medications in a Regional Managed Care Plan

D’Souza¹,

Smith²,

Miller³

et al. 2008

JMCP

201

166

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BACKGROUND: Pharmacotherapy constitutes an important adjunct to behavioral therapy for the treatment of overactive bladder (OAB). Tolterodine and oxybutynin are commonly prescribed drugs for OAB treatment that exert their beneficial effect by suppressing bladder muscle contractions. However, high discontinuation rates have been observed for these drugs in clinical trials, as well as in real-world settings, in part due to adverse effects. Extended-release (ER) formulations were introduced with an improved tolerability profile over immediate-release (IR) versions of the 2 drugs. No study has compared persistence and adherence to therapy for both the ER and IR versions of tolterodine and oxybutynin.OBJECTIVE: To compare persistence, adherence, and switch rates for the IR and ER formulations of oxybutynin and tolterodine for patients enrolled in a regional managed care plan.METHODS: Study patients were adults (aged ≥ 18 years), with at least 1 pharmacy claim for either tolterodine extended-release (tol-ER), oxybutynin extended-release (oxy-ER), tolterodine immediate-release (tol-IR), or oxybutynin immediate-release (oxy-IR) during the period from July 1, 1999, to December 31, 2003, and were continuously eligible for benefits from 6 months before through 12 months after the initial OAB pharmacy claim (index) date. A retrospective cohort study design was used following patients from the index date to the occurrence of non-persistence with the index medication (i.e., a gap of > 45 days between successive prescription fills or a switch to any other OAB medication), or the end of a 1-year follow-up period, through December 31, 2004. Switching was defined as any change from the index medication, including a change in dose form (e.g., tol-IR to tol-ER), to one of the other 3 study drugs, or to a different OAB treatment (e.g., trospium chloride, oxybutynin patch, flavoxate, hyoscyamine sulfate, or propantheline bromide) during the follow-up period. Adherence was measured as the proportion of patients with a medication possession ratio (MPR) of at least 80%. MPR was calculated as (1) the sum of days supply for all pharmacy claims except the last pharmacy claim, divided by (2) the total number of days from the first fill date to the fill date of the last pharmacy claim. The association of drug therapy with study outcomes was assessed with bivariate and adjusted (multivariate) analyses. Multivariate analyses controlled for demographic and clinical characteristics, plan type, patient out-of-pocket cost for the index medication, and year of therapy initiation. RESULTS: 1,117 patients had at least 1 pharmacy claim for an OAB study drug (n = 454 for tol-ER [40.6%], n = 249 for oxy-ER [22.3%], n = 306 for tol-IR [27.4%], n = 108 for oxy-IR [9.7%]), of whom 81.6% were women. The mean (standard deviation [SD]) age of the study population was 55.7 (14.5) years. Only 53.7% had at least 1 OAB diagnosis recorded during the 18-month eligibility period. 44.5% of patients did not have a refill after the initial (index) pharmacy clai...

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confidence: 58%

Section: ■■ Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

See 2 more Smart Citations

Persistence, Adherence, and Switch Rates Among Extended-Release and Immediate-Release Overactive Bladder Medications in a Regional Managed Care Plan

D’Souza¹,

Smith²,

Miller³

et al. 2008

JMCP

201

166

View full text Add to dashboard Cite

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“…This leads to poor adherence in treated patients with as high as 70-90% of patients discontinuing their medication within the first year of treatment [9][10][11][12][13] . BOTOX * (onabotulinumtoxinA), a purified neurotoxin complex, is indicated for the management of overactive bladder with symptoms of urinary incontinence, urgency and frequency, in adult patients who are not adequately managed with anticholinergics [14,15] .…”

Section: Introductionmentioning

confidence: 99%

Economic impact of onabotulinumtoxinA for overactive bladder with urinary incontinence in Europe

Ruff

Bagshaw

Aracil

et al. 2016

Journal of Medical Economics

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Predictors of Persistence of Use of the Novel Antidiabetic Agent Acarbose

Catalan

Couture²,

LeLorier³

2001

Arch Intern Med

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New users of acarbose showed low persistence in 2 cohorts of beneficiaries of Quebec's provincial health plan. Prescribing specialist was an important predictor of persistence in seniors and the socially assisted. The importance of 4 additional factors in seniors only led to hypotheses concerning population differences in treatment expectations and in the occurrence and tolerance of adverse effects.

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Incontinence Drug Utilization Patterns in Québec, Canada

Abstract: Drug claim renewal rates were low for both oxybutynin and flavoxate, suggesting that money spent on these therapies provides an inadequate clinical return on investment since the majority of patients discontinue treatment prematurely.

Cited by 20 publications

References 23 publications

Persistence, Adherence, and Switch Rates Among Extended-Release and Immediate-Release Overactive Bladder Medications in a Regional Managed Care Plan

Persistence, Adherence, and Switch Rates Among Extended-Release and Immediate-Release Overactive Bladder Medications in a Regional Managed Care Plan

Economic impact of onabotulinumtoxinA for overactive bladder with urinary incontinence in Europe

Predictors of Persistence of Use of the Novel Antidiabetic Agent Acarbose

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