Falls/fractures are major causes of morbidity and mortality among older adults and the resulting health consequences generate a substantial economic burden. Risk factors are numerous and include overactive bladder (OAB) and anticholinergic use.
We aimed to estimate the impact of falls/fractures on all-cause healthcare resource utilization and costs, according to levels of cumulative anticholinergic burden, among individuals with OAB.
Among a US cohort of adults with OAB (identified based on medical claims for OAB or OAB-specific medications), the frequency of resource utilization (outpatients visits, medication use, and hospitalizations) was examined according to level of anticholinergic burden. Anticholinergic burden was assessed cumulatively using a published measure, and categorized as no, low, medium, or high. Resource utilization prior to and after a fall/fracture was compared. Generalized linear models were used to examine overall and incremental changes in healthcare resource utilization and costs by fall/fracture status, and annual costs were predicted according to age, sex, fall/fracture status, and level of anticholinergic burden.
The mean age of the OAB cohort (n = 154,432) was 56 years, 68% were female, and baseline mean anticholinergic burden was 266.7 (i.e. a medium level of burden); a fall/fracture was experienced by 9.9% of the cohort. All estimates of resource utilization were higher among those with higher levels of anticholinergic burden, regardless of fall/fracture status, and higher for all levels of anticholinergic burden after a fall/fracture. Among those with a fall/fracture, the highest predicted annual costs were observed among those aged 66-75 years with high anticholinergic burden (US$22,408 for males, US$22,752 for females).
Falls/fractures were associated with higher costs, which increased with increasing anticholinergic burden.
PharmacoEconomics - open. 2020 Apr 14 [Epub ahead of print]
Greta Lozano-Ortega, Carol R Schermer, David R Walker, Shelagh M Szabo, Basia Rogula, Alison M Deighton, Katherine L Gooch, Noll L Campbell
Broadstreet Health Economics and Outcomes Research, 203-343 Railway St, Vancouver, BC, V6A 1A4, Canada., Medical Affairs, Americas, Astellas Pharmaceutical Global Development Inc., Northbrook, IL, USA., Broadstreet Health Economics and Outcomes Research, 203-343 Railway St, Vancouver, BC, V6A 1A4, Canada. ., College of Pharmacy, Purdue University, West Lafayette, IN, USA.