Related Experiment Video
Updated: Mar 31, 2026
Transcorporal Artificial Urinary Sphincter Cuff Placement in a Case Requiring Revision for Urethral Atrophy
Published on: June 16, 2022
Adherence to Oral Therapy for Urgency Urinary Incontinence: Results from the Anticholinergic Versus Botox Comparison
Anthony G Visco1, Linda Brubaker, J Eric Jelovsek
1From the *Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, NC; †Departments of Obstetrics and Gynecology and Urology, Stritch School of Medicine, Loyola University Chicago, Chicago, IL; ‡Obstetrics, Gynecology and Women's Health Institute, Cleveland Clinic, Cleveland, OH; §Department of Urology, University of Alabama at Birmingham, Birmingham, AL; ∥Department of Obstetrics and Gynecology, University of Utah, Salt Lake City, UT; ¶Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh, Pittsburgh, PA; **Department of Biostatistics, University of Michigan, Ann Arbor; ††Department of Urology, Beaumont Health System, OUWB School of Medicine, Royal Oak, MI; ‡‡Department of Obstetrics and Gynecology, Kaiser Permanente Downey, Downey, CA; §§Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, TX; ∥∥Gynecologic Health and Disease Branch, The Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD and ¶¶RTI International, Research Triangle Park, NC.
Objectives:
Medication adherence with urgency urinary incontinence (UUI) treatment is challenging and the best assessment methodology is uncertain. We sought to describe adherence with anticholinergic (AC) versus placebo (P) by comparing pill counts and MEMSCAP event data and to identify factors associated with adherence.
Methods:
The randomized controlled AC versus Botox Comparison trial of women with moderate to severe idiopathic UUI included 126 participants initiating AC plus P bladder injection and 121 receiving P pills plus Botox injection. Adherence data on 243 participants (124 AC and 119 P) were calculated by pill count and MEMSCAP data for each 2-month interval during the 6-month study that allowed for dose escalation/drug change. Overall composite adherence estimates were calculated using the average of both methods and weighted by the duration of each 2-month interval.
Results:
Treatment groups had no significant differences in dosing duration (P = 0.76) or mean adherence (AC, 83.3% [16.8] vs. P, 84.8% [13.8]). Only 53% of women met the dichotomous outcome of more than 80% adherence during all intervals. Correlation between adherence by pill counts versus MEMSCAP decreased over time with pill counts demonstrating higher adherence than MEMSCAP (r = 0.53, 0.50, and 0.36 for each 2-month interval). Lower adherence was associated with higher baseline incontinence severity and better UUI quality of life for the AC group and with current smoking status in both groups.
Conclusions:
Adherence using pill counts and MEMSCAP was reasonably correlated and similar in both the AC and P groups. In the AC group, higher baseline incontinence severity and better UUI Quality of Life were associated with decreased adherence. Smokers were less adherent.
Related Concept Videos
01:30Urinary Tract Calculi III: Medical Management
01:30Urinary Tract Infection III: Diagnostic Studies and Interprofessional Care
01:25Urinary Tract Calculi VI: Surgical Management
01:17Drugs for Treatment of Diarrhea-Predominant IBS
Two specific drugs used in the treatment are alosetron (Lotronex) and eluxadoline (Viberzi). Alosetron, a 5-HT3 antagonist, works by slowing the movement of stools in the gut, reducing bowel...
01:27Urinary Tract Calculi IV: Nutrition Therapy and Prevention
01:17Urinary Tract Infection IV: Nursing Management