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SUFU 2022: Identifying Navigator Impact on Utilization of Onabotulinumtoxina as a 3rd Line Treatment in Overactive Bladder: A Retrospective Database Study in the United States

(UroToday.com) Only 10% of patients with OAB progress to third line options (onabotulinumtoxinA [onabotA] and neuromodulation). Reasons include a lack of understanding of options, fear of side effects, or desire to avoid invasive treatments. Using a navigator, defined as a healthcare professional focused on patient-centered care), to guide the patient through the OAB care pathway may optimize treatment utilization. This group compared prevalence rates of patients progressing to onabotA and continuing treatment with and without a patient navigator.


Precision Point Specialty Analytics Portal, an electronic medical record database covering over 2.4 million community-based urology patients, was used to identify adult patients diagnosed and treated for non-neurogenic OAB between January 1, 2015, and December 31, 2019. Identification was through ICD-9, ICD-10, and procedure codes. Included in the analysis were patients with a minimum of two OAB clinic visits at least 30 days apart. A subset of eligible patients was randomly selected and stratified into navigation and non-navigation groups. Treatment continuation was defined as retreatment within 12-months.

This retrospective analysis yielded a total of 9,000 patients (navigated care [n=1,151] and non-navigated care [n=7,849]) randomly selected from the 170,000 patients who met all study inclusion criteria. Navigated-care and non-navigated care patients were most likely to be treated at a medium sized urology practice (34.9% and 35.8%, respectively). Mean age at diagnosis (index date) was 63.5 ± 16.9 years (64.0 navigated and 63.5 non-navigated) and 59.9% of patients were female (81.7% navigated vs. 56.7% non-navigated; p <0.001).

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Navigated care was more likely to advance patients to a third line treatment or specifically to onabotA versus non-navigated care (both p <0.001; Table 1) and the proportion of patients continuing onabotA treatment significantly improved with navigated care versus non-navigated care (p=0.042; Table 1).

The authors concluded that navigated patient-centered care can significantly increase utilization of third line treatment options such as onabotA and improved treatment continuation.

Presented by: Raveen Syan, MD,1 Jennifer Miles-Thomas, MD,2 Diane K. Newman, DNP, FAAN, BCB-PMD,3 Nitya Abraham, MD,4 Keely Madaj, MPH,5 Krystal Anson Spenta, MPH,6 Amin Boroujerdi, PhD,6 Zhanying Bai, MS,7 Lei Luo, MPH,7 Ekene Enemchukwu, MD, MPH8

  1. University of Miami Miller School of Medicine, Miami
  2. Urology of Virginia, Virginia Beach
  3. University of Pennsylvania Perelman School of Medicine, Philadelphia
  4. Montefiore Medical Center, Bronx
  5. PPS Analytics, Independence
  6. AbbVie, Irvine, CA
  7. AbbVie, Madison, NJ
  8. Stanford University School of Medicine, Stanford

Written by: Diane K. Newman, DNP, ANP-BC, FAAN, Adjunct Professor of Urology in Surgery, Perelman School of Medicine, University of Pennsylvania and Co-Director of the Penn Center for Continence and Pelvic Health at the 2022 Society of Urodynamics, Female Pelvic Medicine & Urogenital Reconstruction (SUFU) Winter Meeting, February 22 - 26, 2022