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Overactive bladder: special considerations in the geriatric population.

J G Ouslander, Y T Shih, J Malone-Lee

    The American Journal of Managed Care
    |February 24, 2001
    PubMed
    Summary
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    Overactive bladder (OAB) significantly impacts older adults, increasing healthcare costs. Future research must identify cost-effective OAB treatments for long-term care settings.

    Area of Science:

    • Geriatrics
    • Urology
    • Health Economics

    Background:

    • Overactive bladder (OAB) is a prevalent condition in older adults, leading to significant healthcare utilization and costs.
    • The demand for OAB services is projected to increase substantially over the next three decades.
    • OAB treatment is complex, influenced by patient age, cognition, and mobility.

    Purpose of the Study:

    • To review the challenges and costs associated with overactive bladder in the geriatric population.
    • To evaluate current treatment options for OAB, particularly in long-term care settings.
    • To highlight the need for cost-effective OAB management strategies for older adults.

    Main Methods:

    • Retrospective analysis of a large managed care database.
    • Review of pharmacotherapy options, including tolterodine and oxybutynin (muscarinic antagonists).

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  • Assessment of non-pharmacological interventions like prompted voiding in institutionalized care.

    • Main Results:

    • An age-related increase in women seeking care for OAB was observed.
    • Caring for incontinent patients in long-term care incurs substantial additional costs, escalating with episode frequency.
    • Prompted voiding shows limited efficacy (40%) and is labor-intensive for institutionalized patients.

    Conclusions:

    • OAB poses a growing challenge in geriatric care, demanding effective and economical management.
    • Current treatments may have varying efficacy and side effect profiles in older populations.
    • Further research is essential to determine the most cost-effective OAB treatments for long-term care settings.