Anticholinergic medications are a core treatment strategy for overactive bladder (OAB). There is evidence that exposure to anticholinergic medications is associated with an increased risk of developing dementia. We launched an initiative to inform our patients of this risk and give them an opportunity to engage in shared decision-making about their treatment. This quality improvement initiative encompassed 3 aims: (1) to evaluate the feasibility of 2 different routes to deliver the written outreach; (2) to evaluate if and how patients changed their OAB treatment; and (3) to assess satisfaction with the outreach initiative.
A query was performed via the electronic medical record for all patients who had been prescribed an anticholinergic for treatment of OAB. We sent either electronic messages or traditional mail to patients. We contacted patients by telephone to assess if they received the message, were satisfied with their respective method of communication, and decided for ongoing treatment. Health care provider satisfaction was also measured.
Of the 231 patients sent the outreach, 32 were still taking the anticholinergic at the time they received the communication. The majority of patients, 84.38%, were satisfied with the initiative and elected to change therapy after learning about the increased risk of dementia. The physicians also uniformly reported satisfaction with the initiative.
Overall, this outreach initiative resulted in an increase in patient counseling that led to a change in treatment for most patients. This initiative was received favorably by patients and health care providers.
Female pelvic medicine & reconstructive surgery. 2022 Mar 01 [Epub]
Hannah Millimet, Kerac Falk, Jessica Harroche, Annalise Littman, Nina Metcalfe, Gina M Northington
From the Department of Obstetrics and Gynecology, Barnes Jewish Hospital, Washington University School of Medicine, St. Louis, MO., Department of Obstetrics and Gynecology, University of Nevada Reno School of Medicine, Reno, NV., Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta., Emory University School of Medicine, Atlanta, GA.