Ganz Michael L, Liu Jieruo, Zou Kelly H, Bhagnani Tarun, Luo Xuemei
a Evidera , Waltham , MA , USA.
b Pfizer Inc. , New York , NY , USA.
Curr Med Res Opin. 2016 Dec;32(12):1997-2005. doi: 10.1080/03007995.2016.1226167. Epub 2016 Sep 20.
Although much has been published about the demographic and clinical characteristics of elderly patients with overactive bladder (OAB) who were enrolled in clinical trials, very little is known about the general population of elderly Americans with OAB. We update this gap in the literature by using real-world data to describe this population.
We used Medicare claims and the Medicare Current Beneficiary Surveys from 2006 to 2011 to identify patients with OAB. We describe the demographic characteristics, functional impairment and physical limitations, concurrent medical conditions, Charlson Comorbidity Index (CCI) scores, and concomitant medication use of patients with OAB; these characteristics are also described by sex and age group (65-74 vs. ≥75 years). We also compare the characteristics of OAB with non-OAB patients.
We identified 415 elderly patients with OAB (average age 79 years; 71% female) and 6868 without OAB (average age 77 years; 62% female). Patients with OAB reported high levels of functional impairment as measured by the Activities of Daily Living (44% vs. 33% for non-OAB patients), Instrumental ADL (53% vs. 40% for non-OAB patients), and physical functioning limitation (90% vs. 81% for non-OAB patients) scales. Elderly patients with OAB also experienced high levels of comorbidity burden, as measured by the number of medical conditions (18 vs. 11 for non-OAB patients), CCI (2.1 vs. 1.4 for non-OAB patients), and number of non-OAB-related concomitant medications used (11 vs. 8 for non-OAB patients).
Elderly patients with OAB in the general population have high levels of functional impairment and physical limitations, comorbidity, and concomitant medication use. These characteristics should be taken into consideration when managing OAB symptoms and designing future clinical studies. These results, which are representative of elderly patients with OAB in the general US population, should, however, be interpreted in light of the key limitations of the data we used: patients may have been misclassified and medical conditions overestimated due to artifacts of diagnosis coding and our results can only be generalized to patients who were enrolled in Medicare Parts A, B, and D for at least 12 continuous months.
尽管已有大量关于参加临床试验的老年膀胱过度活动症（OAB）患者的人口统计学和临床特征的报道，但对于美国患有OAB的老年普通人群知之甚少。我们通过使用真实世界数据来描述这一人群，以填补文献中的这一空白。
我们使用2006年至2011年的医疗保险理赔数据和医疗保险当前受益人调查来识别OAB患者。我们描述了OAB患者的人口统计学特征、功能障碍和身体限制、并发疾病、查尔森合并症指数（CCI）评分以及伴随用药情况；这些特征也按性别和年龄组（65 - 74岁与≥75岁）进行了描述。我们还比较了OAB患者与非OAB患者的特征。
我们识别出415名老年OAB患者（平均年龄79岁；71%为女性）和6868名非OAB患者（平均年龄77岁；62%为女性）。根据日常生活活动量表（OAB患者为44%，非OAB患者为33%）、工具性日常生活活动量表（OAB患者为53%，非OAB患者为40%）和身体功能限制量表（OAB患者为90%，非OAB患者为81%）测量，OAB患者报告的功能障碍水平较高。老年OAB患者的合并症负担也较高，以疾病数量（OAB患者为18种，非OAB患者为11种）、CCI（OAB患者为2.1，非OAB患者为1.4）以及使用的非OAB相关伴随药物数量（OAB患者为11种，非OAB患者为8种）衡量。
普通人群中的老年OAB患者存在高水平的功能障碍、身体限制、合并症和伴随用药情况。在管理OAB症状和设计未来临床研究时应考虑这些特征。然而，鉴于我们所使用数据的关键局限性，这些代表美国普通人群中老年OAB患者的结果应谨慎解读：由于诊断编码的假象，患者可能被错误分类且疾病情况被高估，并且我们的结果仅能推广至至少连续12个月参加医疗保险A、B和D部分的患者。
