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Baseline Anticholinergic Medication Burden in Patients with Overactive Bladder.

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Summary

Many women with overactive bladder (OAB) have high anticholinergic cognitive burden (ACB) scores, increasing risks. Safer alternatives and addressing cost barriers are crucial for improved OAB management.

Keywords:
AnticholinergicsBeta-3 agonistsCognitive burdenOveractive bladderUrogynecology

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Area of Science:

  • Urogynecology
  • Geriatric Medicine
  • Pharmacology

Background:

  • Overactive bladder (OAB) affects many women, often managed with medications.
  • Anticholinergic medications carry a risk of cognitive burden (ACB), particularly concerning in older adults.
  • Quantifying ACB scores in OAB patients is essential for safe and effective treatment.

Purpose of the Study:

  • To determine baseline Anticholinergic Cognitive Burden (ACB) scores in women with overactive bladder (OAB) symptoms.
  • To identify patient characteristics linked to elevated ACB scores.
  • To evaluate the association between ACB scores and OAB treatment choices.

Main Methods:

  • Retrospective analysis of 242 new female patients with OAB symptoms at an academic urogynecology practice.
  • Abstraction of baseline characteristics and medications from electronic health records.
  • Assessment of ACB scores using a validated scale and review of subsequent OAB treatments.

Main Results:

  • Median ACB score was 1; 37% of patients had high-risk scores (≥3).
  • Anticholinergics were prescribed to 3% of patients, 71% with high-risk ACB.
  • High-risk ACB scores correlated with comorbidities and increased likelihood of sacral neuromodulation.
  • Beta-3 agonists were prescribed to 15%, but 43% cited cost as a barrier.

Conclusions:

  • A significant proportion of women with OAB present with high-risk ACB scores.
  • Careful assessment is needed due to cognitive risks of anticholinergics.
  • Promoting safer alternatives like beta-3 agonists and addressing cost barriers can optimize OAB care.