To understand factors guiding overactive bladder (OAB) therapy selection and experience with combination therapy (antimuscarinics and beta-3 agonists).
Cross-sectional surveys of OAB patients and OAB-treating physicians in the USA were conducted. Patients receiving monotherapy with antimuscarinics were categorized by OAB treatment history: monotherapy only; third-line procedures (e.g., onabotulinumtoxinA injections) and combination therapy; third-line therapy only; and combination therapy only. The patient survey assessed therapy choice drivers and barriers, treatment satisfaction and sociodemographic/clinical characteristics. The physician survey assessed drivers of and barriers to OAB treatment choices.
Of 200 patients, 86.5% reported involvement in treatment decision-making; doctor's recommendation was the most frequently considered factor (84.4%). Most patients (71%) were unaware of combination therapy. The primary reason why those patients aware of combination therapy had not used it (N = 43/200; 21%) was physician recommendation of other treatments (69.8%). For physicians (N = 50), the most frequently considered factors when prescribing OAB treatment were effectiveness (92.0%) and side effects (84.0%); 70% prescribed combination therapy, primarily for symptom severity (82.9%). The main reasons for not prescribing combination therapy were cost/insurance coverage (80%) and lack of information (53.3%).
Shared decision-making guided treatment decisions; the main considerations were treatment safety and efficacy.
The Journal of international medical research. 2022 May [Epub]
Stephen R Kraus, Junlong Li, Rita M Kristy, Amy Lockefeer, Hongbo Yang, Mo Zhou, David R Walker
University of Texas Health Sciences Center, San Antonio, TX, USA., Analysis Group, Inc., Boston, MA, USA., Astellas Pharma Global Development, Inc., Northbrook, IL, USA.