Effectiveness of an intervention to optimise the use of mirabegron for overactive bladder: a quasi-experimental study in primary care
| Autor: | Pere Vivó Tristante, Maria Josep López Dolcet, Josep Ossó Rebull, Eladio Fernández-Liz, Maria Estrella Barceló Colomer, Antonio Aranzana Martínez |
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| Rok vydání: | 2018 |
| Předmět: |
Male
medicine.medical_specialty Urinary system 030232 urology & nephrology Primary care 03 medical and health sciences 0302 clinical medicine Intervention (counseling) medicine Humans 030212 general & internal medicine Adverse effect Aged Aged 80 and over Primary Health Care Urinary Bladder Overactive business.industry Research Middle Aged medicine.disease Discontinuation Thiazoles Treatment Outcome Overactive bladder Controlled Before-After Studies Spain Physical therapy Urological Agents Acetanilides Female Deprescribing Family Practice Mirabegron business Follow-Up Studies medicine.drug |
| Zdroj: | British Journal of General Practice. 68:e852-e859 |
| ISSN: | 1478-5242 0960-1643 |
| DOI: | 10.3399/bjgp18x699953 |
| Popis: | BackgroundOveractive bladder is a composite of lower urinary tract storage symptoms. Pharmacological treatment is widely employed despite markedly modest efficacy data, adverse effects, and costs for the health system.AimTo determine the 12-month efficacy of an intervention delivered by GPs on mirabegron revision and, if appropriate, discontinuation of treatment.Design and settingMulticentre, quasi-experimental study in Barcelona (Catalonia), Spain.MethodTwo groups composed of 17 intervention and 34 control practices were formed. The follow-up period was 12 months, from 1 January to 31 December 2017. A structured intervention was designed consisting of initiatives with GPs and urology/gynaecology specialists. The primary outcome was mirabegron use at 12 months.ResultsOf the 1932 patients, a significant discontinuation in treatment was observed at 12 months’ follow-up in the intervention group (IG) (n= 433 out of 762, 56.8%), in contrast with the control one (CG) (n= 484 out of 1170, 41.4%) (Pn= 214 out of 762, 28.1%) compared with the CG (n= 595 out of 1170, 50.9%) (PPConclusionThe structured intervention showed optimisation in the use of mirabegron. When considering discontinuation it is necessary to provide clear data on the benefits and/or risks for patients and their caregivers, as such information is a precondition for shared decision making. |
| Databáze: | OpenAIRE |
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