Department of Social Sciences, School of Humanities, Far Eastern Federal University, Vladivostok, Russian Federation.; Department of Theory and Methods of Adaptive Physical Education, Far Eastern Federal University, Vladivostok, Russian Federation.
Department of Urology, City Polyclinic No. 3, Vladivostok, Russian Federation.
Investig Clin Urol. 2017 Mar;58(2):109-116. doi: 10.4111/icu.2017.58.2.109. Epub 2017 Feb 1.
Comparison of subjective reasons for the refusal of antimuscarinic treatment and the state of objective economic, social, psychological and health status markers in the elderly with overactive bladder.
One thousand seven hundred thirty-six (1,736) patients participated in the experiment: 1,036 or 59.7% of women, and 700 or 40.3% of men aged over 60 years (average age, 68.1 years) who took antimuscarinic (AM) drugs during the year. The control of objective parameters was carried out by studying patients' medical records, the use of overactive bladder questionnaire short form and Medical Outcomes Study 36-item Shor-Form Health Survey, voiding diaries, uroflowmetry, as well as income certificates from the Tax Inspectorate, support documentation for expenses on drugs.
Fifty-two point six percent (52.6%) of patients preserved adherence to treatment during the first 6 months, 30.1% - during the follow-up period. The average time of reaching a 30-day break in the AM drugs administration was 174 days. In 36.5% of cases of the refusal of treatment, patients referred to medical reasons for the refusal, in 31.6% of cases disturbance was established in objective health status markers (differences were significant in 30% of the follow-up time). The percentage of refusals of treatment for social and psychological reasons (13.2%) was significantly lower (p≤0.05), than the percentage of individuals with statuses altered objectively (21.9%).
A significant share of elderly patients taking AM drugs when treating overactive bladder is inclined to overestimate the importance of health factors influencing their decisions and to underestimate the importance of social and psychological factors, and an urologist should take it into account for the efficacy evaluation.
比较拒绝使用抗毒蕈碱药物的主观原因和客观经济、社会、心理和健康状况标志物在老年膀胱过度活动症患者中的状态。
1736 名患者参与了实验：1036 名或 59.7%为女性，700 名或 40.3%为 60 岁以上的男性（平均年龄为 68.1 岁），在一年内服用了抗毒蕈碱（AM）药物。通过研究患者的病历、使用膀胱过度活动症问卷短表和医疗结果研究 36 项简明健康调查、排尿日记、尿流率，以及税务监察局的收入证明、药物费用支持文件，对客观参数进行了控制。
52.6%的患者在最初的 6 个月内保留了对治疗的依从性，30.1%的患者在随访期间保留了对治疗的依从性。达到 AM 药物治疗中断 30 天的平均时间为 174 天。在 36.5%拒绝治疗的情况下，患者提到了拒绝治疗的医学原因，在 31.6%的情况下，客观健康状况标志物发生了改变（在 30%的随访时间内差异显著）。因社会和心理原因拒绝治疗的比例（13.2%）明显较低（p≤0.05），而客观状态改变的比例（21.9%）较高。
在治疗膀胱过度活动症时，服用 AM 药物的老年患者中有相当大的一部分倾向于高估影响其决策的健康因素的重要性，低估社会和心理因素的重要性，泌尿科医生在评估疗效时应考虑到这一点。
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