Urinary Incontinence Medications: Patient-Initiated Concerns in Primary Care.

Autor:	Neuner J; From the Department of Medicine, Medical College of Wisconsin, Milwaukee, WI., Schmitt E; University of Wisconsin School of Medicine and Public Health, Madison, WI., Winn A; Department of Pharmacy Systems, Outcomes and Policy, School of Pharmacy, University of Illinois at Chicago, Chicago, IL., Davidson E; Department of Obstetrics and Gynecology, Medical College of Wisconsin, Milwaukee, WI., O'Connor RC; Department of Urology, Medical College of Wisconsin, Milwaukee, WI., Marowski S; Medical College of Wisconsin, Milwaukee, WI., Luebke M; Medical College of Wisconsin, Milwaukee, WI., Balza J; Medical College of Wisconsin, Milwaukee, WI., Attewell M; Center for Advancing Population Science, Medical College of Wisconsin, Milwaukee, WI., Flynn KE; From the Department of Medicine, Medical College of Wisconsin, Milwaukee, WI.
Jazyk:	angličtina
Zdroj:	Urogynecology (Philadelphia, Pa.) [Urogynecology (Phila)] 2024 Jun 21. Date of Electronic Publication: 2024 Jun 21.
DOI:	10.1097/SPV.0000000000001540
Abstrakt:	Importance: Guideline-recommended medications for overactive bladder and urge urinary incontinence (OAB/UUI) are effective but have high costs and side effects. Little is known about patient concerns regarding these medications when prescribed by their primary care providers (PCPs). Objective: The aim of the study was to describe PCP-patient interactions when prescribing medications for OAB/UUI, specifically clinical concerns, cost and authorization issues, and mode of communication for these interactions. Study Design: Using electronic health records, we identified a retrospective cohort of women aged 18-89 years who were prescribed a medication for OAB/UUI during a primary care office visit from 2017 to 2018. We examined the electronic health record from initial prescription through 15 subsequent months for documentation of prior authorization requests and patient concerns about cost, side effects, or ineffectiveness. The association of patient demographics, comorbidity, and medication class with these concerns was examined with logistic regression models. Results: Overall, 46.2% of patients (n = 123) had 1 or more OAB/UUI medication concerns, and 52 reported outside an office visit. Only higher comorbidity was associated with reduced concern of any type. Although the overall percent age of patients reporting concerns was similar by medication type, the patterns of concern type varied. Compared with those taking short-acting antimuscarinics, patients taking long-acting antimuscarinics other than oxybutynin were less likely to have side effect concerns (adjusted odds ratio 0.35, 95% CI 0.16-0.78) and more likely to have cost concerns (adjusted odds ratio 5.10, 95% CI 1.53-17.03). Conclusions: Patient concerns regarding OAB/UUI medications were common in primary care practices and frequently reported outside of office visits. However, the patterns of concerns (cost vs side effects) varied between medication classes. Competing Interests: The authors have declared they have no conflicts of interest. (Copyright © 2024 American Urogynecologic Society. All rights reserved.)
Databáze:	MEDLINE
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