Use of Third Line Therapy for Overactive Bladder in a Practice with Multiple Subspecialty Providers: Beyond the Abstract
In addition, anticholinergic medications are associated with a risk of cognitive decline with long-term use, and this relationship has been shown to be dose-dependent.4 Although causality has not been established, there is a plausible mechanism for this association with dementia which can further worsen overall health and well-being. It is important to counsel patients that if they are not getting satisfactory relief of OAB symptoms on medications, they should seek alternative treatment.
Overall, third line therapy should be used in a larger proportion of patients with refractory OAB. At this time we believe that the primary barrier to progression to third line therapy is lack of knowledge about these treatments amongst both physicians and patients. By promoting awareness and knowledge about third line therapy we can improve the quality and efficiency of care for OAB patients.
Written by: Dena Moskowitz and Kathleen C Kobashi
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4 Gray, S.L., M.L. Anderson, S. Dublin, et al., Cumulative use of strong anticholinergics and incident dementia: a prospective cohort study. JAMA Intern Med, 2015. 175(3): p. 401-7.