To describe prescription prevalence of oral bladder pain medications among women with interstitial cystitis/bladder pain syndrome (IC/BPS) and to compare with current treatment guidelines.
We sampled female patients with an ICD-9/10 diagnosis of IC/BPS (595. 1/N30.10) by querying active users of the Veterans Health Administration. Medical records were reviewed to determine whether patients met IC/BPS diagnostic criteria. A cohort of women with other pelvic pain disorders was identified. Prescription prevalence of typical non-narcotic oral bladder pain medications was compared between the two groups and healthy controls. Prescription prevalence was also compared before and after the diagnosis of IC/BPS was made using Poisson regression.
There were 641 women who met criteria for IC/BPS and 197 women with "Other pelvic pain" disorders. Women with IC/BPS were prescribed a pain medication more often than those with "Other pelvic pain" (77% vs. 59%, p < 0.0001). Of the women with IC/BPS, 44% tried three or more pain medications. Of women with a diagnosis of IC/BPS, only 67% were prescribed an American Urological Association-recommended medication. Prescription prevalence increased after diagnosis for both pentosan polysulfate (10%-29%, p < 0.0001) and hydroxyzine (17%-40%, p < 0.0001), but not for amitriptyline or cimetidine. Amitriptyline was prescribed to 223 women with IC/BPS, only 125 of which (56%) had a documented history of depression.
Many women with IC/BPS required multiple bladder prescriptions, highlighting the difficulty in finding an effective treatment for IC/BPS. Pentosan polysulfate and hydroxyzine were preferred IC/BPS medications. Our next step will be to analyze treatment patterns in those patients who did not receive medications.
Neurourology and urodynamics. 2022 Apr 07 [Epub ahead of print]
Lauren N Tholemeier, Catherine Bresee, Amanda M De Hoedt, Kamil E Barbour, Jayoung Kim, Stephen J Freedland, Jennifer T Anger
Department of Obstetrics and Gynecology, Cedars-Sinai Medical Center, Los Angeles, California, USA., Biostatistics Core at the Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA., Durham Veterans Affairs Health System, Durham, North Carolina, USA., Centers for Disease Control and Prevention, Atlanta, Georgia, USA., Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, California, USA., Department of Surgery, Division of Urology, Cedars-Sinai Medical Center, Los Angeles, California, USA., Department of Urology, UC San Diego Medical Center, La Jolla, California, USA.