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  • 1Division of Female Pelvic Medicine and Reconstructive Surgery, Departments of Urology and Obstetrics and Gynecology, New York University, New York, New York; the Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, Georgia; the Department of Obstetrics, Gynecology and Reproductive Science, Yale School of Medicine, New Haven, Connecticut; the Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynecology, Women & Infants Hospital of Brown University, Providence, Rhode Island; the Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics, Gynecology, and Reproductive Medicine, Icahn School of Medicine at Mount Sinai, New York, New York; the Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynecology, Hartford Hospital, Hartford, Connecticut; the Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynecology, Northwestern University, Chicago, Illinois; the Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynecology, MedStar Washington Hospital Center and Georgetown University School of Medicine, Washington, DC; the Center for Urogynecology and Pelvic Reconstructive Surgery, Cleveland Clinic, Cleveland, Ohio; the Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynecology, Montefiore Medical Center and Albert Einstein School of Medicine, Bronx, New York; the Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynecology, Loyola University, Chicago, Illinois; the Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynecology, University of California, Irvine School of Medicine, Irvine, California; the Division of Urogynecology, Department of Obstetrics and Gynecology, Oregon Health & Science University, Portland, Oregon; and the Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics, Gynecology, and Women's Health, University of Louisville School of Medicine, Louisville, Kentucky.

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Summary
This summary is machine-generated.

Idiopathic overactive bladder (OAB) oral medications, like anticholinergics, can cause dementia. Beta-3 adrenoceptor agonists offer similar efficacy with fewer cognitive risks but face access barriers, worsening health inequities.

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Area of Science:

  • Urology
  • Pharmacology
  • Health Equity

Background:

  • Idiopathic overactive bladder (OAB) significantly impacts quality of life.
  • Oral medications are a cornerstone of OAB management.
  • Anticholinergics, a common OAB treatment, are linked to cognitive side effects like dementia.

Purpose of the Study:

  • To evaluate the comparative efficacy and safety of oral OAB treatments.
  • To examine the impact of cost and access barriers on OAB medication choices.
  • To highlight the contribution of medication access to health care inequality.

Main Methods:

  • Literature review of OAB treatment efficacy and side effect profiles.
  • Analysis of cost variations and access barriers for OAB pharmacotherapies.
  • Discussion of health equity implications in OAB management.

Main Results:

  • Beta-3 adrenoceptor agonists demonstrate comparable efficacy to anticholinergics.
  • Beta-3 adrenoceptor agonists possess a more favorable cognitive side effect profile.
  • Significant cost variations and access restrictions limit patient access to preferred OAB medications.

Conclusions:

  • Access barriers to beta-3 adrenoceptor agonists exacerbate health disparities for OAB patients.
  • Prescribing decisions involve balancing medication efficacy, safety, and patient cost.
  • Multilevel collaboration is essential to address OAB health inequalities and improve patient care.