Kim Tae Heon, Choo Myung-Soo, Kim Young-Joo, Koh Hyein, Lee Kyu-Sung
Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, #81 Irwon-ro, Gangnam-gu, Seoul, 135-710, Republic of Korea.
Department of Urology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
Qual Life Res. 2016 Aug;25(8):2021-9. doi: 10.1007/s11136-015-1216-z. Epub 2015 Dec 24.
To evaluate persistence and compliance for patients receiving antimuscarinics for overactive bladder (OAB), and to assess patient-reported outcomes (PROs) according to persistence and compliance.
This was a 24-week, multicenter, prospective, observational study that included 952 OAB patients who had newly started antimuscarinics. Patients aged ≥18 years with a total OAB Symptom Score (OABSS) ≥3 and an urgency score of OABSS ≥2 were eligible for the study. Drug persistence and compliance were evaluated at 4, 12, and 24 weeks. Changes in scores on PROs were compared between groups (persistence vs. non-persistence and compliance vs. non-compliance) after 24 weeks. Factors contributing to persistence were examined using multivariate logistic regression.
After 24 weeks, 56.8 % of patients remained on treatment. The persistence rates were 85.6 and 71.4 % after 4 and 12 weeks, respectively. The compliance rates were 75.6, 53.8, and 34.3 % after 4, 12, and 24 weeks, respectively. Patients who were persistent in taking antimuscarinics resulted in significant improvements in OABSS and OAB questionnaire short form score compared with those who were non-persistent (all p < 0.05). Changes from baseline in OABSS (p = 0.735) and the EuroQoL five-dimensions score (p = 0.384) were not significantly different between compliant and non-compliant groups. Predictors of high persistence included older age (OR 1.017, p = 0.007) and dry OAB (OR 1.422, p = 0.013).
Patients who were persistent with antimuscarinics showed significant improvements in PROs compared to those who were non-persistent.
评估接受抗毒蕈碱药物治疗膀胱过度活动症(OAB)患者的持续性和依从性,并根据持续性和依从性评估患者报告结局(PRO)。
这是一项为期24周的多中心前瞻性观察性研究,纳入952例新开始使用抗毒蕈碱药物的OAB患者。年龄≥18岁、总OAB症状评分(OABSS)≥3且OABSS急迫性评分≥2的患者符合研究条件。在第4、12和24周评估药物持续性和依从性。24周后比较两组(持续性与非持续性、依从性与非依从性)PRO评分的变化。使用多因素逻辑回归分析导致持续性的因素。
24周后,56.8%的患者仍在接受治疗。第4周和12周后的持续性率分别为85.6%和71.4%。第4、12和24周后的依从率分别为75.6%、53.8%和34.3%。与非持续性患者相比,持续服用抗毒蕈碱药物的患者在OABSS和OAB问卷简表评分方面有显著改善(所有p<0.05)。依从组和非依从组之间,OABSS(p=0.735)和欧洲五维健康量表评分(p=0.384)相对于基线的变化无显著差异。高持续性的预测因素包括年龄较大(比值比1.017,p=0.007)和无尿失禁的OAB(比值比1.422,p=0.013)。
与非持续性患者相比,持续使用抗毒蕈碱药物的患者在PRO方面有显著改善。