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Published in: Current Bladder Dysfunction Reports 1/2024

08-01-2024 | Overactive Bladder | REVIEW

Overactive Bladder: the Patient Perspective

Authors: Victoria S. Edmonds, Aqsa A. Khan

Published in: Current Bladder Dysfunction Reports | Issue 1/2024

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Abstract

Purposeof Review

Given that the diagnosis and management of overactive bladder (OAB) is directed by symptomatology, the patient perspective is critical to understanding the disease and efficacy of available treatments. We present a narrative review of literature published in the last 5 years surrounding the patient perspective of OAB.

Recent Findings

OAB has a negative effect on health-related quality of life (HRQoL). Management of OAB generates significant cost to the patient, including physician visits, incontinence pads, treatment of urinary tract infections, and management of skin infections and irritation. Patients with OAB suffer in terms of work productivity, food insecurity, and financial strain, and these effects are more profound in patients of lower socioeconomic status and education level. Recent literature investigating the effect of β3-adrenergic agonists on patient quality of life demonstrated similar improvements when compared with anticholinergics and potentially greater tolerability in terms of adverse effects. In terms of third-line therapies, sacral neuromodulation (SNM) has been shown to have significant improvement in HRQoL and urinary symptoms while avoiding the need for frequent office visits.

Summary

OAB can have a detrimental effect on HRQoL, sexual function, work productivity, and can generate significant cost to the patient. Recent literature demonstrates that existing treatments show promise in terms of improving HRQoL. Patients prefer oral medications over injectable or more invasive therapies; however, a majority of patients who fail medications are willing to trial third-line therapies. Continued investigation of the patient perspective on OAB will be paramount to continue improvement in patient care.
Literature
16.
go back to reference •• Tellechea L, Zuo S, Kohn JR, Fazzari MJ, Eisenberg R, Lee J, et al. The effect of social determinants of health on overactive bladder symptom severity. J Urol. 2021;205(5):1415–20. https://doi.org/10.1097/ju.0000000000001545. Cross-sectional study demonstrating higher OAB symptom scores are associated with food insecurity, financial strain, difficulty finding or keeping employment, and difficulty concentrating after adjusting for age, race, and BMI. •• Tellechea L, Zuo S, Kohn JR, Fazzari MJ, Eisenberg R, Lee J, et al. The effect of social determinants of health on overactive bladder symptom severity. J Urol. 2021;205(5):1415–20. https://​doi.​org/​10.​1097/​ju.​0000000000001545​. Cross-sectional study demonstrating higher OAB symptom scores are associated with food insecurity, financial strain, difficulty finding or keeping employment, and difficulty concentrating after adjusting for age, race, and BMI.
21.
go back to reference • Herschorn S, Staskin D, Tu LM, Fialkov J, Walsh T, Gooch K, et al. Patient-reported outcomes in patients with overactive bladder treated with mirabegron and tolterodine in a prospective, double-blind, randomized, two-period crossover, multicenter study (PREFER). Health Qual Life Outcomes. 2018;16(1):69. https://doi.org/10.1186/s12955-018-0892-0. Phase IV double-blind crossover study that compared mirabegron and tolterodine ER in treatment-naïve adults with OAB and demonstrated similar improvements in OAB symptom scores. • Herschorn S, Staskin D, Tu LM, Fialkov J, Walsh T, Gooch K, et al. Patient-reported outcomes in patients with overactive bladder treated with mirabegron and tolterodine in a prospective, double-blind, randomized, two-period crossover, multicenter study (PREFER). Health Qual Life Outcomes. 2018;16(1):69. https://​doi.​org/​10.​1186/​s12955-018-0892-0. Phase IV double-blind crossover study that compared mirabegron and tolterodine ER in treatment-naïve adults with OAB and demonstrated similar improvements in OAB symptom scores.
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go back to reference •• Staskin D, Frankel J, Varano S, Shortino D, Jankowich R, Mudd PN Jr. International phase III, randomized, double-blind, placebo and active controlled study to evaluate the safety and efficacy of vibegron in patients with symptoms of overactive bladder: EMPOWUR. J Urol. 2020;204(2):316–24. https://doi.org/10.1097/ju.0000000000000807. Phase III placebo- and active-controlled trial demonstrating the efficacy and safety of vibegron for treatment of OAB. •• Staskin D, Frankel J, Varano S, Shortino D, Jankowich R, Mudd PN Jr. International phase III, randomized, double-blind, placebo and active controlled study to evaluate the safety and efficacy of vibegron in patients with symptoms of overactive bladder: EMPOWUR. J Urol. 2020;204(2):316–24. https://​doi.​org/​10.​1097/​ju.​0000000000000807​. Phase III placebo- and active-controlled trial demonstrating the efficacy and safety of vibegron for treatment of OAB.
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go back to reference ••Huang J, Fan Y, Zhao K, Yang C, Zhao Z, Chen Y, et al. Comparative efficacy of neuromodulation technologies for overactive bladder in adults: a network meta-analysis of randomized controlled trials. Neuromodulation. 2022. https://doi.org/10.1016/j.neurom.2022.06.004. Meta-analysis of clinical trials investigating the efficacy and perceived improvement of third-line therapies demonstrated SNM was the most effective for HRQoL improvement, urinary episodes, and urinary frequency. ••Huang J, Fan Y, Zhao K, Yang C, Zhao Z, Chen Y, et al. Comparative efficacy of neuromodulation technologies for overactive bladder in adults: a network meta-analysis of randomized controlled trials. Neuromodulation. 2022. https://​doi.​org/​10.​1016/​j.​neurom.​2022.​06.​004. Meta-analysis of clinical trials investigating the efficacy and perceived improvement of third-line therapies demonstrated SNM was the most effective for HRQoL improvement, urinary episodes, and urinary frequency.
Metadata
Title
Overactive Bladder: the Patient Perspective
Authors
Victoria S. Edmonds
Aqsa A. Khan
Publication date
08-01-2024
Publisher
Springer US
Published in
Current Bladder Dysfunction Reports / Issue 1/2024
Print ISSN: 1931-7212
Electronic ISSN: 1931-7220
DOI
https://doi.org/10.1007/s11884-023-00727-1

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