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在老年人中使用多种微创性过活性膀疗法;国家医疗保险研究
Abigail Shatkin-Margolis1, Adam Crow2, Lufan Wang3
1Department of Obstetrics and Gynecology, University of California, San Francisco, California, USA.
Neurourology and urodynamics
|November 13, 2025
概括
超过16%的老年人在两年内使用了一次以上的微创性过活性膀治疗 (MIT). 这凸显了对这些常见的OAB治疗需要更好的患者咨询和后续治疗的需要.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 老年病的医生 老年病的医生
- 医疗保健服务研究 医疗服务研究
背景情况:
- 最少侵入性过活性膀 (OAB) 疗法,包括皮肤穿神经刺激 (PTNS),胺毒素A (BTX) 和神经神经调节 (SNM),经常在老年人中使用.
- 在这个人口群体中,在两年内连续使用多种最小侵入性OAB疗法的数据有限.
研究的目的:
- 调查医疗保险受益者在初始治疗两年内使用多种最少侵入性OAB疗法 (MIT) 的比例和模式.
- 为了确定与初始手术后启动不同的MIT相关的患者特异性因素.
主要方法:
- 一项回顾性队列研究分析了2015年至2020年期间接受首次MIT的收费医疗保险受益者.
- 主要结果是在两年内启动一个不同的麻省理工学院. 桑基图可视化治疗序列,多变量修改的波桑回归确定了相关的患者因素.
主要成果:
- 在获得第一个MIT的111,939名受益者中,16.5%在两年内启动了不同的MIT.
- 最常见的序列是PTNS,其次是BTX (29.1%),BTX由SNM (20.9%),SNM由BTX (20.0%).
- 与更换治疗方法的可能性增加相关的因素包括PTNS作为初始治疗,女性性别和更高的脆弱性. 年龄较大和非白人种族与更低的转换概率有关.
结论:
- 很大一部分 (16.5%) 的医疗保险受益者在两年内使用了一次以上的微创OAB疗法.
- 这些发现强调了设置现实的患者期望的重要性,并为接受OAB治疗的个人提供密切的监测和后续.
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