The Relative Importance of Health Related Quality of Life and Prescription Insurance Coverage in the Decision to Pharmacologically Manage Symptoms of Overactive Bladder

Harpe, Spencer E.; Szeinbach, Sheryl L.; Caswell, Robert J.; Corey, R; McAuley, James W.

doi:10.1016/j.juro.2007.08.006

Cited by 18 publications

(16 citation statements)

References 14 publications

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“…Data regarding actual drug intake obtained from patients themselves are not provided, as recognized by the authors. The findings of Campbell et al [28] regarding lower compliance with higher expenditures and that of Sears et al [29] and Harpe et al [30] regarding higher treatment compliance when free AM drugs are available also accord well with our data.…”

Section: Discussionsupporting

confidence: 92%

Social, Economic, and Medical Factors Associated With Solifenacin Therapy Compliance Among Workers Who Suffer From Lower Urinary Tract Symptoms

et al. 2016

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PurposeThe prevalence of hyperactive-type lower urinary tract symptoms is 45.2%, with shares of overactive bladder (OAB) and urge incontinence (UI) symptoms of 10.7% and 8.2%, respectively. We investigated the possible impact of a wide range of social, economic, and medical factors on compliance with solifenacin treatment in the working population.MethodsSocial, economic, and medical factors as well as the Overactive Bladder questionnaire – the OAB-q Short Form (OAB-q SF), bladder diaries, and uroflowmetry of 1,038 people who were administered solifenacin for a year were gathered from employer documentation.ResultsAmong the subjects, 32% maintained their compliance with solifenacin treatment throughout the year. Only 65% of the patients had compliance exceeding 80%, and 17% of patients had compliance of ≥50%, yet less than 80% were still taking solifenacin 12 months after the beginning of this experiment. Working people whose compliance level was, at least, 80% had reliably higher (P≤0.01) average age, annual salary, and treatment efficacy, and a greater treatment satisfaction level, as well as a lack of satisfaction with other antimuscarinic treatments and higher rate of urge UI diagnosis. The same cohort also featured a lower level (P≤0.01) of caffeine abuse and lower share of salary spent purchasing solifenacin.ConclusionsThis study has shown that compliance with solifenacin treatment is associated with a number of significant medical, social, and economic factors. The medical factors included the type of urination disorder, severity of incontinence symptoms, presence of side effects, treatment efficacy and patients’ satisfaction with it, and experience using other antimuscarinic treatments. Among the social and economic factors, those with the strongest correlation to compliance were patient age, employment in medicine and education, annual income level, percentage of solifenacin purchase expenditures, and caffeine abuse. Factors with a weaker, but still significant, association were gender, employment in the transportation industry, and monthly income level.

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Section: Discussionsupporting

confidence: 92%

Social, Economic, and Medical Factors Associated With Solifenacin Therapy Compliance Among Workers Who Suffer From Lower Urinary Tract Symptoms

et al. 2016

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“…This is in contrast to results from a study in which OAB patients not currently using medication completed a questionnaire simultaneously rating 5 attributes of treatment. 19 Using conjoint analysis techniques, all 5 parameters were significant considerations (all P < 0.001), with prescription drug coverage of greatest importance to patients followed by sleep disturbances, symptom concern, social interaction problems, and coping. Thus, given that paying the full medication cost was a determining factor in the decision to seek pharmacotherapy, it is interesting to note that our study did not demonstrate any impact of OOP cost on drug persistence or adherence rates.…”

mentioning

confidence: 98%

“…In fact, 1 study found that prescription drug coverage was the most important factor determining patient preference for drug therapy. 19 The present study addresses these issues by simultaneously comparing both ER and IR forms of tolterodine (tol-ER, tol-IR) and oxybutynin (oxy-ER, oxy-IR, respectively) using various measures of adherence to treatment and accounting for additional relevant factors not previously addressed. The present study was limited to these 4 OAB compounds, because the number of patients using these drugs during the study period was sufficient to allow for statistically meaningful analysis.…”

mentioning

confidence: 99%

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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“…By economic reasons are meant references to the low income level, the need for substantial expenses on drugs and medical services, etc. [ 19 20 ]. If indicated reasons for the refusal included AM drug administration anxiety, the aversion to AM drugs, prior confidence in its inefficacy, the lack of social support from family members, friends, the limitation of social contacts related to the need to use pads, obsessive fear of unpleasant odor spreading, etc., we verified these reasons as a sociopsychological [ 20 ].…”

Section: Methodsmentioning

confidence: 99%

“…The patients' adherence increases in older age with a good awareness of their disease [ 14 15 ]. Several researchers present data on significant influence on adherence to AM treatment of factors such as the drug cost [ 16 ], the income level, expense interest on AMs and other drugs, as well as disability, depression and psycho-emotional problems caused by a decrease in the social adaptation level [ 17 18 19 20 ]. Some researchers indicate the lack of a systematic approach studying the influence on the adherence of various factors, as well as the complexity of its objective evaluation [ 21 ], the need to study the “rational nonadherence to regime” and a discrepancy between reasons for the refusal of treatment indicated by patients and actual motivation [ 22 ].…”

Section: Introductionmentioning

confidence: 99%

Long-term adherence to antimuscarinic drugs when treating overactive bladder in the older: Subjective reason and objective factors

et al. 2017

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PurposeComparison of subjective reasons for the refusal of antimuscarinic treatment and the state of objective economic, social, psychological and health status markers in the elderly with overactive bladder.Materials and MethodsOne thousand seven hundred thirty-six (1,736) patients participated in the experiment: 1,036 or 59.7% of women, and 700 or 40.3% of men aged over 60 years (average age, 68.1 years) who took antimuscarinic (AM) drugs during the year. The control of objective parameters was carried out by studying patients' medical records, the use of overactive bladder questionnaire short form and Medical Outcomes Study 36-item Shor-Form Health Survey, voiding diaries, uroflowmetry, as well as income certificates from the Tax Inspectorate, support documentation for expenses on drugs.ResultsFifty-two point six percent (52.6%) of patients preserved adherence to treatment during the first 6 months, 30.1% – during the follow-up period. The average time of reaching a 30-day break in the AM drugs administration was 174 days. In 36.5% of cases of the refusal of treatment, patients referred to medical reasons for the refusal, in 31.6% of cases disturbance was established in objective health status markers (differences were significant in 30% of the follow-up time). The percentage of refusals of treatment for social and psychological reasons (13.2%) was significantly lower (p≤0.05), than the percentage of individuals with statuses altered objectively (21.9%).ConclusionsA significant share of elderly patients taking AM drugs when treating overactive bladder is inclined to overestimate the importance of health factors influencing their decisions and to underestimate the importance of social and psychological factors, and an urologist should take it into account for the efficacy evaluation.

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The Relative Importance of Health Related Quality of Life and Prescription Insurance Coverage in the Decision to Pharmacologically Manage Symptoms of Overactive Bladder

Abstract: Prescription insurance coverage and sleep disturbances are important considerations underlying patient preferences for the treatment of overactive bladder.

Cited by 18 publications

References 14 publications

Social, Economic, and Medical Factors Associated With Solifenacin Therapy Compliance Among Workers Who Suffer From Lower Urinary Tract Symptoms

Social, Economic, and Medical Factors Associated With Solifenacin Therapy Compliance Among Workers Who Suffer From Lower Urinary Tract Symptoms

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

Long-term adherence to antimuscarinic drugs when treating overactive bladder in the older: Subjective reason and objective factors

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