Patient preferences for treating refractory overactive bladder in the UK

Area of Science:

• Urology
• Patient-Reported Outcomes
• Medical Device Technology

Background:

• Refractory overactive bladder (OAB) significantly impacts quality of life.
• Current treatment options for refractory OAB include sacral neuromodulation (SNM), onabotulinum toxin A (Botox), and percutaneous tibial nerve stimulation (PTNS).
• Understanding patient preferences is crucial for optimizing treatment selection.

Purpose of the Study:

• To evaluate and compare patient preferences for three refractory OAB treatments: SNM, Botox, and PTNS.
• To identify specific treatment characteristics that influence patient choice among these therapies.
• To inform shared decision-making for refractory OAB management.

Main Methods:

• A cross-sectional web survey was administered to UK patients with idiopathic OAB.
• Patient preferences were assessed using direct questioning and best-worst scaling (BWS) of 13 influential treatment attributes.
• BWS scores were analyzed to compare attribute importance based on preferred treatment.

Main Results:

• Among patients with prior OAB medication experience, 57% preferred PTNS, 34% SNM, and 9% Botox.
• Patients preferring SNM valued the implanted device and test phase.
• Patients preferring Botox favored the injection procedure, while those preferring PTNS prioritized minimal side effects and repeated treatments.

Conclusions:

• Specific attributes of SNM, Botox, and PTNS significantly influence patient preferences in refractory OAB.
• These identified characteristics can guide clinicians in shared decision-making processes.
• Tailoring treatment discussions to patient-valued attributes may improve adherence and outcomes.