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Preferences for antimuscarinic therapy for overactive bladder.
Paul Swinburn1, Andrew Lloyd, Shehzad Ali
1Oxford Outcomes Ltd, Oxford, UK. Paul.Swinburn@oxfordoutcomes.com
BJU International
|November 26, 2010
Summary
Patients with overactive bladder (OAB) prioritize avoiding incontinence episodes above other symptom improvements. Even minor adverse events significantly influence treatment choices.
Area of Science:
- Urology
- Patient-Reported Outcomes
- Pharmacoeconomics
Background:
- Overactive bladder (OAB) significantly impacts quality of life.
- Antimuscarinic treatments are common for OAB but associated with adverse events.
- Understanding patient preferences is crucial for optimizing OAB management.
Purpose of the Study:
- To investigate patient preferences for overactive bladder (OAB) symptom management.
- To determine the strength of preferences for symptom reduction versus adverse event avoidance.
- To evaluate patient trade-offs between treatment efficacy and tolerability.
Main Methods:
- A discrete choice experiment (DCE) survey was administered to 332 OAB patients.
- Treatment choices were presented based on symptom efficacy and adverse event likelihood.
- Data were analyzed using a conditional logit model to calculate marginal rates of substitution.
Main Results:
- Patients strongly preferred avoiding urgency incontinence episodes.
- Reduced urinary urgency and micturition frequency were also highly valued.
- The likelihood of experiencing adverse events substantially influenced treatment preferences, comparable to symptom improvements.
Conclusions:
- Overactive bladder (OAB) patients prioritize symptom relief, especially incontinence avoidance.
- Incontinence avoidance is valued more highly than reductions in urgency or micturition frequency.
- Even small increases in adverse event likelihood can drive significant shifts in treatment preference.
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