Factors Influencing Medication Selection for Management of Overactive Bladder: Trends and Insights From AUA Quality Registry.

Autor: Bowman M; University of California San Francisco, Department of Urology, San Francisco, CA. Electronic address: max.bowman@ucsf.edu., Vélez CA; Universidad Central del Caribe, School of Medicine, Bayamon, PR., Jericevic D; New York University Langone, Department of Urology, New York, NY., Shapiro K; New York University Langone, Department of Urology, New York, NY., Mbassa R; American Urological Association, Linthicum, MD., Fang R; American Urological Association, Linthicum, MD., Brucker BM; New York University Langone, Department of Urology, New York, NY., Van Kuiken M; University of California San Francisco, Department of Urology, San Francisco, CA.
Jazyk: angličtina
Zdroj: Urology [Urology] 2024 Feb; Vol. 184, pp. 51-57. Date of Electronic Publication: 2023 Dec 09.
DOI: 10.1016/j.urology.2023.11.021
Abstrakt: Objective: 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 (OAB).
Methods: We queried the AUA Quality Registry for adults between 2014 and 2020 with a diagnosis of OAB for >1year, 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.
Results: We found 1,453,566 patients with OAB, 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 vs 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 nonacademic settings were associated with increased odds of beta-3 prescription. There was no difference between genders.
Conclusion: Many nonclinical factors, including insurance type and race, may affect which medication is first prescribed for OAB. This is useful for practicing urologists and may help lower barriers to beta-3 prescription through policy change and advocacy.
Competing Interests: Declaration of Competing Interest Benjamin Brucker - Sumitomo Pharma America - Advisor, speaker and Investigator. Abbvie - Advisor, speaker and Investigator. Watkins Conti - Advisor. Teleflex - Advisor. The remaining authors have no conflict of interest to declare.
(Copyright © 2023 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
Externí odkaz: