Antimuscarinic Use in Men Treated With Bladder Outlet Obstruction Medication Therapy

Area of Science:

• Urology
• Pharmacology
• Health Services Research

Background:

• Bladder outlet obstruction (BOO) affects adult men, often managed with alpha blockers and 5-alpha reductase inhibitors.
• Antimuscarinics (AM) are used for lower urinary tract symptoms, but their use in conjunction with BOO therapy is not well-defined over time.
• Previous studies indicated rising AM use, but recent clinical guidelines and trials may have influenced prescribing patterns.

Purpose of the Study:

• To evaluate temporal trends in antimuscarinic (AM) utilization among adult men receiving medication for bladder outlet obstruction (BOO).
• To determine if AM use has changed over time in men treated with alpha blockers and 5-alpha reductase inhibitors.
• To identify potential gaps in prescribing practices for AM in the context of BOO management.

Main Methods:

• Analysis of the National Ambulatory Medicare Care Survey database from 2006 to 2014.
• Inclusion of men aged 40 and older initiating or continuing BOO medication therapy.
• Multivariable logistic regression used to assess trends in AM use over the study period.

Main Results:

• The study analyzed approximately 158 million US patient visits for men aged 40+ on BOO therapy.
• Antimuscarinics (AM) were used in 3.7% of these visits, with higher usage noted in older men.
• No statistically significant increasing trend in AM use was observed from 2006 to 2014 (P=.8104).

Conclusions:

• Despite prior trends, antimuscarinic use did not increase among men treated for bladder outlet obstruction between 2006 and 2014.
• The findings suggest a potential underutilization of antimuscarinics in this patient population.
• There is an opportunity to improve prescribing practices for antimuscarinics in men with BOO.