Percutaneous tibial neuromodulation initial therapy compliance and subsequent third-line treatment patterns

Area of Science:

• Urology
• Neuromodulation
• Overactive Bladder Treatment

Background:

• Percutaneous Tibial Neuromodulation (PTNM) is a third-line treatment for Overactive Bladder (OAB).
• Understanding patient adherence to PTNM is crucial for optimizing treatment outcomes.
• Limited data exists on adherence rates and subsequent use of alternative therapies.

Purpose of the Study:

• To summarize patient adherence to PTNM for OAB.
• To examine trends in the use of other third-line therapies during and after PTNM.
• To compare third-line therapy use between compliant and noncompliant PTNM patients.

Main Methods:

• Retrospective analysis of deidentified patient data from Optum's Clinformatics® Data Mart Database (CDM) and CMS Research Identifiable Files (2019-2020).
• Inclusion criteria: adults with OAB symptoms undergoing PTNM.
• Adherence defined as completing 12 PTNM visits within 12 weeks; analysis of third-line therapy use post-PTNM, stratified by compliance.

Main Results:

• 2302 patients (CDM) and 16,473 patients (CMS) met criteria.
• Proportion of patients completing a full PTNM course increased over time (16%-42% in CDM, 24%-38% in CMS).
• Noncompliant patients showed higher use of onabotulinumtoxinA and sacral neuromodulation (SNM) trial procedures compared to compliant patients.

Conclusions:

• Most patients exhibit noncompliance with the recommended PTNM treatment regimen.
• Noncompliance with PTNM is associated with increased utilization of other third-line therapies.
• Low adherence may compromise PTNM effectiveness, suggesting a need for alternative neuromodulation technologies.