Lawrence M, Guay D R, Benson S R, Anderson M J
Express Scripts Inc., Bloomington, Minnesota 55439-0842, USA.
Pharmacotherapy. 2000 Apr;20(4):470-5. doi: 10.1592/phco.20.5.470.35064.
We evaluated adherence to treatment with immediate-release (IR) oxybutynin (515 patients) and tolterodine (505 patients) for detrusor overactivity through retrospective analysis of a pharmacy claims database. Outcomes included percentage of patients continuing therapy for 6 months, medication possession ratios, and time to discontinuation of therapy. The proportion of patients continuing therapy for 6 months was statistically superior for tolterodine (32%) compared with IR oxybutynin (22%, p<0.001). Medication possession ratios were also superior for patients in the tolterodine group (medians 0.83 and 0.64, ranges 0.11-1.15 and 0.07-1.13, respectively, p<0.001). Oxybutynin was discontinued significantly earlier (mean 45 days) than tolterodine (mean 59 days, p<0.001) and was switched to another therapy more commonly than tolterodine (19% and 14%, respectively). Tolterodine was favored over oxybutynin for several measurements of patient adherence. However, less than one-third of patients continued therapy with either agent for 6 months. The clinical relevance of these differences is unknown.
我们通过对一个药房索赔数据库的回顾性分析，评估了速释型奥昔布宁（515例患者）和托特罗定（505例患者）治疗逼尿肌过度活动症的治疗依从性。结果包括持续治疗6个月的患者百分比、药物持有率以及停药时间。持续治疗6个月的患者比例方面，托特罗定（32%）在统计学上优于速释型奥昔布宁（22%，p<0.001）。托特罗定组患者的药物持有率也更高（中位数分别为0.83和0.64，范围分别为0.11 - 1.15和0.07 - 1.13，p<0.001）。奥昔布宁的停药时间显著早于托特罗定（平均45天对比平均59天，p<0.001），并且转用其他疗法的情况比托特罗定更常见（分别为19%和14%）。在多项患者依从性指标上，托特罗定比奥昔布宁更受青睐。然而，不到三分之一的患者使用这两种药物中的任何一种持续治疗6个月。这些差异的临床相关性尚不清楚。
