Kosilov Kirill V, Loparev Sergey A, Kuzina Irina G, Shakirova Olga V, Zhuravskaya Natalya S, Lobodenko Alexandra
Far Eastern Federal University, Ajax 10, corp.F, office 733, Vladivostok, Primorsky region, Russian Federation.
Department of Urology, City Polyclinic No 3, Vladivostok, Primorsky Region, Russian Federation.
Curr Aging Sci. 2017;10(2):149-156. doi: 10.2174/1874609808666161124143150.
To investigate the heterogeneous factors affecting the stability of patients older than 60 years in the UI treatment with Antimuscarinics.
The prevalence of Urge Incontinence (UI) in older persons reaches 29.3%. The symptoms of urinary incontinence in older people reduce the health related life quality.
In 1257 patients over 60 years (857 (68.2%) women - average age 67.8, 400 (31.8%) men - 71.4), who received AM for one year, demographic, socio-economic and health parameters were studied. OABq-SF questionnaires, MOS SF-36, urination diaries, uroflowmetry, income information from the tax offices and outpatient records were used.
The compliance to AM treatment within 6 months was retained in 44.2%, and within the year - 26.8% of older patients. At least 40% of the total number of patients refused to continue the treatment for medical reasons. The persons taking Solifenacin (p≤ 0.01), Trospium (p≤ 0.05), or Darifenacin (p≤ 0.05), suffering from severe UI symptoms (p≤ 0.01), and experiencing minor side effects (p≤ 0.01), well-informed about UI treatment methods (p≤ 0.01) prevailed among the treatment compliant patients. At least 20.4% of the patients discontinued their treatment due to economic reasons. The persons with significantly larger annual income (p≤ 0.05) and annual medical cost (p≤ 0.01) prevailed among the treatment compliant patients. About 12.2% of the patients stopped their treatment for reasons related to the social background and psychological status.
In this experiment, we found that AM treatment compliance in older patients, in addition to medical parameters and health conditions, is largely affected by the economic as well as social, demographic and psychological factors. The study results can be claimed by practitioners involved in correcting UI symptoms in older people.
探讨影响60岁以上患者使用抗毒蕈碱药物治疗急迫性尿失禁(UI)稳定性的异质性因素。
老年人急迫性尿失禁(UI)的患病率达29.3%。老年人尿失禁症状会降低与健康相关的生活质量。
对1257例60岁以上接受抗毒蕈碱药物治疗一年的患者(857例(68.2%)为女性,平均年龄67.8岁;400例(31.8%)为男性,平均年龄71.4岁)的人口统计学、社会经济和健康参数进行研究。使用膀胱过度活动症问卷简表(OABq-SF)、医学结局研究简明健康调查量表(MOS SF-36)、排尿日记、尿流率测定、税务机关的收入信息及门诊记录。
6个月内抗毒蕈碱药物治疗的依从性在老年患者中为44.2%,一年内在老年患者中为26.8%。至少40%的患者因医学原因拒绝继续治疗。在依从治疗的患者中,服用索利那新(p≤0.01)、曲司氯铵(p≤0.05)或达非那新(p≤0.05)、患有严重UI症状(p≤0.01)、出现轻微副作用(p≤0.01)、充分了解UI治疗方法(p≤0.01)的患者占多数。至少20.4%的患者因经济原因停止治疗。在依从治疗的患者中,年收入(p≤0.05)和年度医疗费用显著更高(p≤0.01)的患者占多数。约12.2%的患者因社会背景和心理状况相关原因停止治疗。
在本实验中,我们发现老年患者对抗毒蕈碱药物治疗的依从性,除医学参数和健康状况外,在很大程度上还受经济以及社会、人口统计学和心理因素影响。参与改善老年人UI症状的从业者可参考本研究结果。