Patient Trust and Medical Mistrust Toward Overactive Bladder Therapies: General Consumer Awareness and Perceptions

Overactive bladder (OAB) is a prevalent condition associated with impaired quality of life, yet many patients do not pursue treatment or minimally invasive therapies (MITs). Physician-patient concordance has been proposed as a factor influencing trust, although its role in OAB care is not well defined. We evaluated the association between physician gender concordance and patient trust, and examined the relationship of trust with health literacy, medical mistrust, and treatment preferences for OAB among broad US consumers.

In this survey-based study, Black and White women were randomized to view 1 of 4 standardized videos describing OAB treatments, differing only by physician race and gender. Trust was dichotomized from a 4-point Likert scale. Participants reported treatment preferences and completed the eHealth Literacy Scale and Group-Based Medical Mistrust Scale. Associations were assessed using chi-square tests and multivariable logistic regressions.

Among 1027 participants, physician gender concordance was not associated with trust (P >.05). Trust was strongly associated with both OAB diagnosis (P = .001) and selection of MITs (P < .001). Higher eHealth literacy independently increased the odds of trust (odds ratio 1.06, P < .001), whereas greater medical mistrust reduced the odds (odds ratio 0.94, P < .001). Income was also independently associated with trust. Race was not an independent predictor, although Black participants reported significantly higher medical mistrust.

Greater patient trust increased likelihood of having an OAB diagnosis and selection of MITs. Health literacy and medical mistrust demonstrated stronger associations with trust than physician gender concordance, highlighting potential areas for improving patient engagement in OAB care.