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C94: Adherence and persistence to antimuscarinic treatment in patients with OAB – a five year analysis
C94: Adherence and persistence to antimuscarinic treatment in patients with OAB – a five year analysis Persu C., Mirciulescu V., Nita G., Paraianu B., Geavlete P. Saint John Clinical Emergency Hospital, Dept. of Urology, Bucharest, Romania INTRODUCTION & OBJECTIVES: Antimuscarinics are recognized as standard therapy for both neurogenic and idiopathic OAB, despite their side effects. Our study aims to evaluate the adherence and persistence to this therapy by the patients in our department.
MATERIAL & METHODS: We retrospectively analyzed the available data for 246 patients in which five years follow up was available. Idiopathic OAB and neurogenic bladders (NgB) were studied separately. Only three antimuscarinic agents could be included: oxybutinine, solifenacin and trospium. Adherence and persistence information were obtained by direct questioning, as no other source was available. Switching to a different medication was considered as non-peristence.
RESULTS: Since adherence could not be objectively measured, the reported value is close to 100%, which we considered unreliable data. Persistence at 12 months, evaluated for all drugs together, was 12% in the idiopathic group and 23% in the NgB group. After 36 months, persistence dropped to 6% for idiopathic and 17% for NgB. The longest persistence for solifenacin was 42 months in idiopathic OAB and 5 years for NgB. For oxybutinine, the longest persistence was at 5 months for idiopathic OAB and 4 years for NgB. Trospium had the longest persistence at 5 months for idiopathic OAB and 3 years for NgB. After 36 months, 19% of the patients started on solifenacin are still taking their drug, compared to 2% for oxybutinine and 13% for trospium. We also noticed a better overall adherence to treatment in older patients.
CONCLUSIONS: The overall adherence to antimuscarinics could not be objectively evaluated, while the persistence is very low. The main risk factors for non-persistence to antimuscarinics are the idiopathic ethiology of OAB, an younger age and being prescripted oxybutinine.
Eur Urol Suppl 2014; 13(6) e1281
MATERIAL & METHODS: We retrospectively analyzed the available data for 246 patients in which five years follow up was available. Idiopathic OAB and neurogenic bladders (NgB) were studied separately. Only three antimuscarinic agents could be included: oxybutinine, solifenacin and trospium. Adherence and persistence information were obtained by direct questioning, as no other source was available. Switching to a different medication was considered as non-peristence.
RESULTS: Since adherence could not be objectively measured, the reported value is close to 100%, which we considered unreliable data. Persistence at 12 months, evaluated for all drugs together, was 12% in the idiopathic group and 23% in the NgB group. After 36 months, persistence dropped to 6% for idiopathic and 17% for NgB. The longest persistence for solifenacin was 42 months in idiopathic OAB and 5 years for NgB. For oxybutinine, the longest persistence was at 5 months for idiopathic OAB and 4 years for NgB. Trospium had the longest persistence at 5 months for idiopathic OAB and 3 years for NgB. After 36 months, 19% of the patients started on solifenacin are still taking their drug, compared to 2% for oxybutinine and 13% for trospium. We also noticed a better overall adherence to treatment in older patients.
CONCLUSIONS: The overall adherence to antimuscarinics could not be objectively evaluated, while the persistence is very low. The main risk factors for non-persistence to antimuscarinics are the idiopathic ethiology of OAB, an younger age and being prescripted oxybutinine.
Eur Urol Suppl 2014; 13(6) e1281