Trends in Overactive Bladder Therapy: Associations Between Clinical Care Pathways, Practice Guidelines, and Therapy Utilization Patterns
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View abstract on PubMed
Summary
This summary is machine-generated.New overactive bladder (OAB) guidelines correlate with increased diagnoses, decreased anticholinergic use, and greater adoption of third-line therapies, especially in older adults. Further studies are needed to confirm long-term impacts.
Area Of Science
- Urology
- Pharmacology
- Health Services Research
Background
- Overactive bladder (OAB) is a prevalent chronic condition with substantial health and economic burdens.
- Clinical guidelines and care pathways aim to standardize OAB diagnosis and management.
- Understanding OAB treatment trends is crucial for optimizing patient care.
Purpose Of The Study
- To evaluate trends in OAB therapy utilization before and after the 2014 AUA/SUFU guideline amendment and 2016 clinical care pathway publication.
- To analyze changes in oral pharmacotherapy and third-line procedural therapy use.
- To identify associations between OAB treatment patterns and patient demographics.
Main Methods
- Retrospective cohort study using a national administrative claims database (2013-2018).
- Identified adult patients with idiopathic OAB using ICD codes.
- Analyzed oral OAB medications (NDC codes) and third-line therapies (onabotulinumtoxinA, SNM, PTNS) using CPT codes.
Main Results
- Over 1.8 million patients were included; new OAB diagnoses surged by 369% (2013-2017).
- Oral medication prescriptions peaked in 2016, declining 17% by 2018; mirabegron use increased, particularly in patients over 65.
- Third-line therapy procedures nearly doubled between 2013 and 2018.
Conclusions
- OAB guidelines appear to influence treatment patterns, with increased diagnoses and shifts in medication use.
- A decrease in anticholinergic use and a rise in beta-3 agonist utilization were observed, especially in older adults.
- Increased adoption of third-line therapies suggests guideline impact, warranting further investigation.
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