Is There a Relationship Between Patient-Reported Satisfaction and Persistence on Overactive Bladder Syndrome Pharmacotherapy?

Objectives This study aimed to determine the relationship between patient satisfaction with overactive bladder syndrome (OAB) pharmacotherapy and persistence rates. We compared persistence rates between satisfied and dissatisfied patients at designated study intervals. Methods This was a retrospective cohort study of new patients who initiated OAB medication. Patients were classified as either satisfied or dissatisfied on the basis of a single-item treatment satisfaction question. Persistence was defined as continuous days on therapy. The measured rate of persistence was determined as the ratio of patients who persisted on medication at 4, 12, and 24 weeks. Data collection included demographic and prescription information; urinary symptom parameters, symptom and quality-of-life scales, and patient-reported outcomes. Two-sample t test or Wilcoxon rank sum test was used to compare continuous outcomes between both groups (satisfied vs not satisfied). &khgr;2 Test or Fisher exact test was used to compare categorical outcomes between groups. Results We analyzed the first 116 charts that met our inclusion criteria. Satisfied and dissatisfied patients did not differ in demographic variables. Satisfied patients had a median of 461 vs 254 persistent days (P = 0.0001). Satisfied patients (12.5% vs 40%) were less likely to discontinue medication (P = 0.0068). The discontinuation-free distribution was significantly different between satisfied and dissatisfied cohorts, favoring those who reported satisfaction with OAB medication at all time points (P < 0.0001). Patients who totally discontinued pharmacotherapy were 7 times more likely to be dissatisfied (odds ratio, 7.0; P = 0.002). Conclusions Our study helps clarify the relationship between persistence on OAB medication and treatment satisfaction. We found that persistence could serve as a surrogate marker for patient satisfaction because those who reported being satisfied were more likely to persist on therapy at all study intervals.

[1]  P. Sand,et al.  Does physician specialty affect persistence to pharmacotherapy among patients with overactive bladder syndrome? , 2017, International Urogynecology Journal.

[2]  J. Grosse,et al.  Refractory overactive bladder: a common problem? , 2015, International Urogynecology Journal.

[3]  R. Goldberg,et al.  An Automatic Female Pelvic Medicine and Reconstructive Surgery Registry and Complications Manager Developed in an Electronic Medical Record , 2014, Female pelvic medicine & reconstructive surgery.

[4]  T. Crook,et al.  An observational study of patient satisfaction with fesoterodine in the treatment of overactive bladder: effects of additional educational material , 2014, International journal of clinical practice.

[5]  S. Kaplan,et al.  Efficacy and safety of fesoterodine 8 mg in subjects with overactive bladder after a suboptimal response to tolterodine ER , 2014, International journal of clinical practice.

[6]  I. Osterloh,et al.  Flexible‐Dose Fesoterodine in Elderly Adults with Overactive Bladder: Results of the Randomized, Double‐Blind, Placebo‐Controlled Study of Fesoterodine in an Aging Population Trial , 2013, Journal of the American Geriatrics Society.

[7]  E. Lukacz,et al.  Minimum important difference for validated instruments in women with urge incontinence , 2011, Neurourology and urodynamics.

[8]  P. Duggan,et al.  Solifenacin for overactive bladder in women unsuccessfully treated with immediate release oxybutynin: A pilot study , 2009, Journal of obstetrics and gynaecology : the journal of the Institute of Obstetrics and Gynaecology.

[9]  N. Zinner,et al.  Darifenacin treatment for overactive bladder in patients who expressed dissatisfaction with prior extended-release antimuscarinic therapy , 2008, International journal of clinical practice.

[10]  K. Burgio Behavior Therapy to Enable Drug Discontinuation in the Treatment of Urge Incontinence: A Randomized Controlled Trial , 2008 .

[11]  K. Coyne,et al.  Patient-reported outcomes in overactive bladder: importance for determining clinical effectiveness of treatment. , 2006, Urology.

[12]  C. Kelleher,et al.  The validation of patient-rated global assessments of treatment benefit, satisfaction, and willingness to continue--the BSW. , 2005, Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research.

[13]  A. Carlberg Patient satisfaction and design of treatment. Results from a study of two different ways of treating hypertension. , 1993, Scandinavian journal of primary health care.