The patient perspective on overactive bladder: a mixed-methods needs assessment

Area of Science:

• Urology
• Patient-centered care
• Healthcare communication

Background:

• Overactive bladder (OAB) is frequently managed in primary care, but under-treatment persists due to barriers like embarrassment and poor adherence.
• Understanding patient perspectives on OAB and urinary symptoms is crucial for addressing these challenges.
• A study aimed to identify patient knowledge, experiences, attitudes, adherence barriers, and communication preferences regarding OAB.

Purpose of the Study:

• To explore patient perspectives on overactive bladder (OAB) and urinary symptoms.
• To identify barriers to treatment adherence for OAB.
• To understand patient desires for clinician communication regarding OAB.

Main Methods:

• A mixed-methods study combining qualitative interviews (n=40) and a quantitative survey (n=200) of patients with OAB or urinary symptoms.
• Qualitative interviews informed the survey design, which was completed by self-selected respondents.
• Both statistical and qualitative analyses were performed on the collected data.

Main Results:

• A significant delay, averaging 3.5 years, exists between symptom onset and physician diagnosis for OAB.
• Many patients do not experience long-term symptom improvement, and medication non-adherence is common, linked to effectiveness and side effects.
• Patients prioritize communication and the patient-physician relationship, preferring clinicians to initiate OAB discussions.

Conclusions:

• The long diagnostic delay highlights the need for improved OAB screening and diagnosis.
• Urinalysis and physical exams, recommended by guidelines, are underutilized in clinical practice for OAB.
• Patient experiences and attitudes toward OAB symptoms often diverge from clinician assumptions, emphasizing the importance of communication.