Objective: To assess the association between incontinence severity, treatment-seeking behavior, and healthcare resource utilization (HRU) among participants with overactive bladder (OAB) in eight countries.
Research Design and Methods: A cross-sectional online survey of subjects ≥18 years old in Australia, Europe, and North America who had a past OAB diagnosis and/or experienced ≥1 urinary incontinence (UI) episode in the preceding 12 months, were eligible to participate. Subjects contacted for the survey were primarily from a voluntary medication monitoring registry, MediGuard. Predominantly stress incontinence subjects were excluded. Incontinence severity was assessed by the number of UI episodes over 3 days and grouped as 0 ("dry"), 1-2, 3-4 and ≥5 UI episodes/day. Subject demographics, employment status, co-morbidities, treatment-seeking behavior (past OAB diagnosis; spoken to healthcare provider [HCP]), and HRU (diagnostic tests; HCP visits in 6 months before screening) were analyzed by incontinence severity.
Results: Overall, 1,341 subjects with OAB (mean age 54.5 years; 70.7% female) were surveyed; 20.2%, 47.7%, 18.8%, 13.3% of subjects reported 0, 1-2, 3-4 and ≥5 UI episodes/day, respectively. Employment status and comorbidities were significantly (P< 0.05) associated with incontinence severity. The two measures of treatment-seeking behavior were significantly (p< 0.05) associated with incontinence severity groups; the proportion of subjects with a past diagnosis of OAB were 35.8%, 44.8%, 52.4%, and 64.0% in the 0, 1-2, 3-4 and ≥5 UI episodes/day groups, respectively; and 59.0%, 63.6%, 65.9%, and 78.1% of subjects in the respective UI severity groups talked to a HCP about their OAB symptoms. Multivariate linear regression analyses showed a positive and consistent association between incontinence severity and HRU; subjects reported a mean of 2.7, 4.1, 4.4, and 7.7 diagnostic tests overall (p< 0.001), and a mean of 1.4, 2.2, 2.7, and 4.0 HCP visits in the 0, 1-2, 3-4 and ≥5 UI episodes/day groups, respectively (p< 0.001). A potential limitation of the study is the cross-sectional survey methodology which limits the ability to draw causal inferences from the results. Additionally, since this is a web-based survey it is possible respondents who have access to/are familiar with technology were more likely to be enrolled.
Conclusions: Incontinence severity was positively associated with both treatment-seeking behavior and HRU among subjects with OAB.
Written by:
Jimenez-Cidre M, Costa P, Ng-Mak D, Sahai A, Degboe A, Smith CP, Tsai K, Herschorn S. Are you the author?
Hospital Universitario Ramon y Cajal, Spain.
Reference: Curr Med Res Opin. 2014 Apr 24. Epub ahead of print.
doi: 10.1185/03007995.2014.918028
PubMed Abstract
PMID: 24762033
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