Contemporary Patterns of Third-line Treatments for Privately Insured Individuals With Overactive Bladder in the United States
| Autor: | James F. Jiang, Jessica Hammett, Elizabeth J. Traore, Dattatraya Patil, Christopher P. Filson |
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| Rok vydání: | 2020 |
| Předmět: |
Adult
Male Health plan medicine.medical_specialty Adolescent Urology Urinary Bladder 030232 urology & nephrology Logistic regression Injections Intramuscular Young Adult 03 medical and health sciences 0302 clinical medicine Older patients Internal medicine medicine Humans Botulinum Toxins Type A Practice Patterns Physicians' Percutaneous tibial nerve stimulation Urinary Bladder Overactive business.industry Middle Aged medicine.disease United States Health Benefit Plans Employee Treatment Outcome Third line Overactive bladder Gynecology 030220 oncology & carcinogenesis Cohort Transcutaneous Electric Nerve Stimulation Health maintenance Female Tibial Nerve business |
| Zdroj: | Urology. 142:87-93 |
| ISSN: | 0090-4295 |
| DOI: | 10.1016/j.urology.2020.04.102 |
| Popis: | OBJECTIVE To evaluate utilization of third-line overactive bladder (OAB) treatments including percutaneous tibial nerve stimulation (PTNS), sacral nerve stimulation (SNS), and intradetrusor botulinum toxin A (BTX) among privately insured patients and examine factors associated with their use. MATERIALS AND METHODS Using MarketScan claims (2015-2017), we identified patients who underwent third-line OAB treatments based on procedure codes. Factors of interest included location, age, health plan, among others. We fit multivariable logistic regression models to estimate associations between pertinent factors with receipt of PTNS and SNS relative to BTX and associations between provider type and practice location with each treatment modality. RESULTS We identified 7383 patients (mean age 50.9) in our cohort. SNS was used most frequently (n = 3602, 48.8%), while PTNS was used least frequently (n = 955, 12.9%). PTNS patients were more likely to reside in metropolitan areas (vs BTX: OR 1.6, 95%CI 1.3-2.1; vs SNS: OR 2.2, 95%CI 1.7-2.8), be aged 55 years or older (vs BTX: 54% vs 47%, OR 1.6, 95%CI 1.2-2.1; vs SNS: 54% vs 45%, OR 1.6, 95%CI 1.2-2.0), and be covered under a health maintenance organization (vs BTX: 17% vs 10%; vs SNS: 17% vs 10%, P |
| Databáze: | OpenAIRE |
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