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Overactive bladder in an integrated delivery system: a longitudinal cohort study.

Jeffrey A Linder1, Joel S Weissman2, Harry Reyes Nieva3

  • 1Division of General Internal Medicine and Geriatrics, Northwestern University Feinberg School of Medicine, 750 N. Lake Shore Drive, 10th Floor, Chicago, IL, 60611, USA. jlinder@northwestern.edu.

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Summary
This summary is machine-generated.

Electronic health record phenotypes identified overactive bladder (OAB) patients. Few OAB patients received medication, and treatment duration was brief, highlighting a gap in OAB care.

Keywords:
Anticholinergic burdenAntimuscarinicsElectronic health recordsIntegrated delivery systemMedication and procedure useOveractive bladderOveractive bladder syndromePrimary and specialty careUrgencyUrinary incontinence

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Area of Science:

  • Geriatrics
  • Urology
  • Pharmacology

Background:

  • Overactive bladder (OAB) is a prevalent and burdensome condition.
  • Current diagnostic and medication claims lack sensitivity for accurate OAB patient identification.
  • Electronic health record (EHR) phenotypes offer a novel approach to identify OAB cases.

Purpose of the Study:

  • To utilize an EHR phenotype to identify patients with overactive bladder.
  • To describe treatment patterns and anticholinergic burden in OAB patients.
  • To analyze predictors for OAB medication receipt.

Main Methods:

  • Retrospective cohort study in a large integrated health system (July 2011-June 2012).
  • Analysis of primary care and specialty clinic data, medication use, and anticholinergic burden.
  • Utilized EHR data to define an OAB phenotype for patient identification.

Main Results:

  • Identified 7362 patients with an EHR OAB phenotype; 50% were over 65, 74% female.
  • Only 40% of patients received OAB medication, with a mean duration of 1.5 months.
  • Higher anticholinergic burden was observed in patients receiving OAB medications compared to those who did not.

Conclusions:

  • Despite OAB's prevalence, a significant proportion of identified patients received brief medication treatment.
  • The study highlights potential underdiagnosis and undertreatment of OAB.
  • EHR phenotypes are valuable for understanding OAB patient characteristics and treatment patterns.