Top

PharmacoEconomics

Published in:

01-04-2009 | Original Research Article

Impact of Transdermal Oxybutynin on Work Productivity in Patients with Overactive Bladder

Results from the MATRIX Study

Authors: Dr Laura T. Pizzi, Amy Talati, Eric Gemmen, Naomi V. Dahl, Thomas J. Bunz, Peter K. Sand

Published in: PharmacoEconomics | Issue 4/2009

Abstract

Background: Overactive bladder syndrome (OAB) is a common condition affecting a significant number of working adults, resulting in increased healthcare utilization, reduced quality of life and decreased work productivity. The MATRIX study was a large, prospective, community-based, observational US study aimed at evaluating the impact of oxybutynin transdermal system (OXY-TDS). In this paper, we report on productivity findings among working adults in MATRIX.

Methods: This study enrolled 2878 adults (aged ≥18 years) with symptoms of OAB from 327 practice sites throughout the US. All subjects received OXY-TDS (3.9 mg/day up to 6 months). Baseline versus end-of-study productivity was measured using the Work Productivity Questionnaire (WPQ). The WPQ includes a subset of questions from the Work Limitations Questionnaire (WLQ) and consists of four scales: (i) physical; (ii) time management; (iii) mental; and (iv) output demands. Overall productivity was measured by the work productivity index score (WPQ Index; a summary score based on scales) and work productivity loss score (WPLS; a measure of reduced output compared with healthy workers). Psychometric performance of the WPQ instrument is also reported, since this study represents the first use of the tool.

Results: Of the participants, 52% were of working age (18–65 years) and 38.6% were employed. A total of 1112 working adults participated in MATRIX and were included in this analysis. They had a mean age of 52.4 years; 92.2% were female and 80.9% were Caucasian. Subjects who reported that they were most affected by OAB were also most impaired at work. After OXY-TDS treatment, participants experienced significant improvements in mean scores for all four WPQ scales (p ≤0.0002) and the mean WPQ Index decreased from 8.2 to 5.5 (p < 0.0001). In addition, the WPLS decreased from 7.7% to 5.2% (p < 0.0001), indicating improvement in work function with OXY-TDS treatment.

Conclusion: OAB contributes to decreased work productivity due to job interruptions as well as fatigue. OXY-TDS may result in productivity improvement when patients receive 3.9 mg/day via twice weekly patch application for up to 6 months.

Milsom I, Abrams P, Cardozo L, et al. How widespread are the symptoms of an overactive bladder and how are they managed? A population-based prevalence study [published erratum appears in BJU Int 2001; 88 (7): 807]. BJU Int 2001; 87 (9): 760–6

Stewart WF, Van Rooyen JB, Cundiff GW, et al. Prevalence and burden of overactive bladder in the United States. World J Urol 2003; 20: 327–36PubMed

Abrams P, Artibani W, Cardozo L, et al. Reviewing the ICS 2002 terminology report: the ongoing debate [letter]. Neurourol Urodyn 2006; 25 (3): 293CrossRef

Hu TW, Wagner TH. Health-related consequences of overactive bladder: an economic perspective. BJU Int 2005; 96 (Suppl. 1): 43–5PubMedCrossRef

Wu EQ, Birnbaum H, Marynchenko M, et al. Employees with overactive bladder: work loss burden. J Occup Environ Med 2005; 47: 439–46PubMedCrossRef

Sand PK, Kelleher C, Pizzi LT, et al. Effect of treatment for overactive bladder on work productivity: results from the MATRIX study [poster]. International Urogynecological Association (IUGA) 31st Annual Meeting; 2006 Sep 6–9; Athens

Milsom I, Irwin DE. A cross-sectional, population-based, multinational study of the prevalence of overactive bladder and lower urinary tract symptoms: results from the EPIC study. European Urology 2007; 6 (1): 4–9CrossRef

Irwin DE, Milsom I, Kopp A, et al. Impact of overactive bladder on symptoms of employment, social interactions and emotional well-being in six European countries. BJU Int 2005; 97: 96–100CrossRef

Hu TW, Wagner TH, Bentkover JD, et al. Estimated economic costs of overactive bladder in the United States. Urology 2003; 61: 1123–8PubMedCrossRef

10.

Grimby A, Milsom I, Molander U, et al. The influence of urinary incontinence on the quality of life of elderly women. Age Ageing 1993; 22: 82–9PubMedCrossRef

11.

Coyne KS, Payne C, Bhattacharyya SK, et al. The impact of urinary urgency and frequency on health-related quality of life in overactive bladder: results from a national community survey. Value Health 2004; 7: 455–63PubMedCrossRef

12.

Ko Y, Lin SJ, Salmon JW, et al. The impact of urinary incontinence on quality of life of the elderly. Am J Manag Care 2005; 11: S103–11

13.

Sand PK, Goldberg RP, Dmochowski RR, et al. The impact of the overactive bladder syndrome on sexual function: a preliminary report from the multicenter assessment of transdermal therapy in overactive bladder with oxybutynin trial. Am J Obstet Gyn 2006; 195: 1730–5CrossRef

14.

Hunskaar S, Vinsnes A. The quality of life in women with urinary incontinence as measured by the sickness impact profile. J Am Geriatr Soc 1991; 39: 378–82PubMed

15.

Kelleher CJ, Cardozo L, Chapple CR, et al. Improved quality of life in patients with overactive bladder symptoms treated with solifenacin. BJU Int 2005; 95: 81–5PubMedCrossRef

16.

Kelleher CJ, Kreder KJ, Pleil AM, et al. Long-term health-related quality of life of patients receiving extended-release tolterodine for overactive bladder. Am J Manag Care 2002; 8: S616–30

17.

Kobelt G, Kirchberger I, Malone-Lee J. Review: quality-of-life aspects of the overactive bladder and the effect of treatment with tolterodine. BJU Int 1999; 83 (6): 583–90PubMedCrossRef

18.

Dmochowski RR, Nitti V, Staskin D, et al. Transdermal oxybutynin in the treatment of adults with overactive bladder: combined results of two randomized clinical trials. World J Urol 2005; 23: 263–70PubMedCrossRef

19.

Davila GW, Daugherty CA, Sanders SW. A short-term, multicenter, randomized double-blind dose titration study of the efficacy and anticholinergic side effects of transdermal compared to immediate release oral oxybutynin treatment of patients with urge urinary incontinence. Transdermal Oxybutynin Study Group. J Urol 2001; 166: 140–5

20.

Dmochowski RR, Davila GW, Zinner NR, et al. Efficacy and safety of transdermal oxybutynin in patients with urge and mixed urinary incontinence. J Urol 2002; 168: 580–6PubMedCrossRef

21.

Dmochowski RR, Sand PK, Zinner NR, et al. Comparative efficacy and safety of transdermal oxybutynin and oral tolterodine versus placebo in previously treated patients with urge and mixed urinary incontinence. Urology 2003; 62: 237–42PubMedCrossRef

22.

Talati AR, Pizzi LT, Dahl N, et al. Validation of the work productivity questionnaire: results of the MATRIX study. ISPOR 11th Annual International Meeting; 2006 May 20–24; Philadelphia (PA)

23.

Coyne KS, Matza LS, Kopp Z, et al. The validation of the patient perception of bladder condition (PPBC): a single-item global measure for patients with overactive bladder. Eur Urol 2006; 49: 1079–86PubMedCrossRef

24.

Kelleher CJ, Reese PR, Pleil AM, et al. Health-related quality of life of patients receiving extended-release tolterodine for overactive bladder. Am J Manag Care 2002; 8: S608–15

25.

Lerner D, Amick III BC, Rogers WH, et al. The work limitations questionnaire. Med Care 2001; 39: 72–85PubMedCrossRef

26.

Talati AR, Pizzi LT, Dahl N, et al. Work productivity in patients with overactive bladder: results from the MATRIX study. ISPOR 11th Annual International Meeting; 2006 May 20–24; Philadelphia (PA)

27.

Zinner N, Noe L, Rasouliyan L, et al. Impact of solifenacin on resource utilization, work productivity, and health utility in overactive bladder patients switching from tolterodine ER. Curr Med Res Opin 2008; 24: 1583–91PubMedCrossRef

28.

Appell RA, Sand PK. Nocturia: etiology, diagnosis, and treatment. Neurourol Urodyn 2008; 27 (1): 34–9PubMedCrossRef

29.

Fultz NH, Fisher GG, Jenkins KR. Does urinary incontinence affect middle-aged and older women’s time use and activity patterns? Obstet Gynecol 2004; 104: 1327–34PubMedCrossRef

30.

Kopec JA, Esdaile JM. Occupational role performance in persons with back pain. Disabil Rehabil 1998 Oct; 20 (10): 373–9PubMedCrossRef

31.

Lofland JH, Pizzi L, Frick KD. A review of health-related workplace productivity loss instruments. Pharmacoeconomics 2004; 22 (3): 165–84PubMedCrossRef

32.

Saha C, Jones MP. Bias in the last observation carried forward method under informative dropout. J Stat Plan Inference 2009; 2 (1): 246–55CrossRef

33.

Lerner D, Amick BC, Lee JC, et al. Relationship of employee-reported work limitations to work productivity. Med Care 2003; 41 (5): 649–59PubMed

34.

Sand P, Zinner N, Newman D, et al. Oxybutynin transdermal system improves the quality of life in adults with overactive bladder: a multicentre, community-based, randomized study. BJU Int 2007 Apr; 99 (4): 836–44PubMedCrossRef

Title: Impact of Transdermal Oxybutynin on Work Productivity in Patients with Overactive Bladder
Results from the MATRIX Study
Authors: Dr Laura T. Pizzi
Amy Talati
Eric Gemmen
Naomi V. Dahl
Thomas J. Bunz
Peter K. Sand
Publication date: 01-04-2009
Publisher: Springer International Publishing
Published in: PharmacoEconomics / Issue 4/2009
Print ISSN: 1170-7690
Electronic ISSN: 1179-2027
DOI: https://doi.org/10.2165/00019053-200927040-00005

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Impact of Transdermal Oxybutynin on Work Productivity in Patients with Overactive Bladder

Results from the MATRIX Study

Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 4/2009

Reviewing the Cost Effectiveness of Rotavirus Vaccination

Cost Effectiveness of Drug-Eluting Stents In Belgian Practice

Willingness to Pay for Cancer Prevention

Clinical Effectiveness and Cost Effectiveness of Tailoring Chronic Hepatitis C Treatment with Peginterferon Alpha-2b Plus Ribavirin to HCV Genotype and Early Viral Response

Economic and Human Costs of Restless Legs Syndrome