To determine how a patient's demographics, including insurance type, race/ethnicity, gender, and age, may impact the choice of medication prescribed for overactive bladder.
We queried the AUA Quality Registry for adults between 2014 and 2020 with a diagnosis of overactive bladder for >1 year, excluding neurogenic causes.
Variables included age, race/ethnicity, gender, insurance type, medication first prescribed, year of prescription, provider metropolitan status, and provider practice type. Primary outcome was which factors were associated with increased odds of beta-3 prescription as first medication choice.
We found 1,453,566 patients with overactive bladder, 641,122 (44.1%) with complete data. Of these, 112,021 (17.5%) were prescribed medication. On multivariate analysis, patients with Medicaid, Medicare, and other/self-pay insurance were less likely to receive a beta-3 versus an anticholinergic compared to private or military insurance. Compared to white patients, Asian, Black, and other races were less likely to receive a beta-3, as were patients outside of metropolitan areas. Age >50, prescriptions after 2014, and non-academic settings were associated with increased odds of beta-3 prescription. There was no difference between genders.
Many nonclinical factors, including insurance type and race, may affect which medication is first prescribed for overactive bladder. This is useful for practicing urologists and may help lower barriers to beta-3 prescription through policy change and advocacy.
Urology. 2023 Dec 09 [Epub ahead of print]
Max Bowman, Camille A Vélez, Dora Jericevic, Katherine Shapiro, Rachel Mbassa, Raymond Fang, Benjamin M Brucker, Michelle Van Kuiken
University of California San Francisco, Department of Urology. Electronic address: ., Universidad Central del Caribe, School of Medicine. Electronic address: ., New York University Langone, Department of Urology. Electronic address: ., New York University Langone, Department of Urology. Electronic address: ., American Urological Association. Electronic address: ., American Urological Association. Electronic address: ., New York University Langone, Department of Urology. Electronic address: ., University of California San Francisco, Department of Urology. Electronic address: .
PubMed http://www.ncbi.nlm.nih.gov/pubmed/38081481