We aimed to understand the reasons patients choose to pursue third line overactive bladder (OAB) therapy.
We conducted a mixed methods study that included patient interviews and survey data. Eligible patients were diagnosed by symptoms, had tried behavioral modifications, and OAB medications enrolled from October 2018 to August 2019. In addition to interviews, patients completed four surveys: the Pelvic Floor Distress Inventory (PFDI-20), Overactive Bladder Questionnaire Short Form (OAB-q SF), Life Orientation Test-Revised (LOT-R), and a patient confidence in the health care system survey. Qualitative interview data were analyzed thematically. Logistic regression and Chi squared analysis was used to analyze survey data.
69 patients were consented, 4 withdrew, and 51 completed both interview and survey data. Overall 55% of patients were Caucasian, 45% were African American, and their average age was 71 (SD=10.4). 75% intended to pursue third line OAB therapy and 31 (61%) expressed interest in a specific third line therapy. Major interview themes included a desire for a better quality of life, embarrassment with accidents, and problems with medication. Themes leading patients away from third line OAB treatment included concern about invasiveness and side effects of treatments, and restrictions to accessing care.
Most patients desired to progress to third line OAB therapy, were motivated by embarrassment, but were concerned about treatment side effects. We found that economic burden of OAB treatment is associated with patient interest in and decision to receive third line therapies to include Botox and PTNS.Brief Summary:Improved quality of life, medication frustration, and concerns about side effects of further therapy are themes patients identified when patients considered third line overactive bladder therapy.
The Journal of urology. 2021 Jun 29 [Epub ahead of print]
Shilpa Iyer, Courtney Amegashie, Victoria deMartelly, Juraj Letko, Dianne Glass, Laura Fetzer, Sylvia Botros, Kristen Wroblewski, Sandra Valaitis
Department of Obstetrics and Gynecology, Division of Female Pelvic Medicine and Reconstructive Surgery, The University of Chicago, Chicago, Illinois., Pritzker School of Medicine, The University of Chicago, Chicago, Illinois., Department of Urology, The University of Texas San Antonio, San Antonio, Texas., Department of Public Health Sciences, The University of Chicago, Chicago, Illinois.