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• W2143567846 abstract "No AccessJournal of UrologyAdult Urology1 Mar 2010Overactive Bladder Medication Adherence When Medication is Free to Patientsis accompanied byAdipose Derived Stem Cells Ameliorate Hyperlipidemia Associated Detrusor Overactivity in a Rat Model Christine L.G. Sears, Christa Lewis, Kathleen Noel, Todd S. Albright, and John R. Fischer Christine L.G. SearsChristine L.G. Sears National Capitol Consortium Fellowship in Female Pelvic Medicine and Reconstruction, Walter Reed Army Medical Center, Washington, D. C. Department of Urology, National Naval Medical Center, Bethesda, Maryland More articles by this author , Christa LewisChrista Lewis Uniformed Services University of the Health Sciences, Bethesda, Maryland More articles by this author , Kathleen NoelKathleen Noel National Capitol Consortium Fellowship in Female Pelvic Medicine and Reconstruction, Walter Reed Army Medical Center, Washington, D. C. More articles by this author , Todd S. AlbrightTodd S. Albright National Capitol Consortium Fellowship in Female Pelvic Medicine and Reconstruction, Walter Reed Army Medical Center, Washington, D. C. Uniformed Services University of the Health Sciences, Bethesda, Maryland More articles by this author , and John R. FischerJohn R. Fischer National Capitol Consortium Fellowship in Female Pelvic Medicine and Reconstruction, Walter Reed Army Medical Center, Washington, D. C. Uniformed Services University of the Health Sciences, Bethesda, Maryland More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2009.11.026AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We examined overactive bladder medication compliance in a health care system in which patients do not pay for medication. Materials and Methods: Pharmacy dispensing records were reviewed for antimuscarinic agents from January 2003 to December 2006 for the United States Military Health System National Capital Region. Medication nonpersistence, switching and adherence were examined. Kaplan-Meier survival analysis was done to compare medication persistence duration. Results: Overactive bladder medications were dispensed to 7,879 adults. Tolterodine extended release (4,716 patients or 60%) and oxybutynin immediate release (2,003 or 25.5%) were most commonly prescribed. The medication nonpersistence rate, defined as the proportion of patients who never refilled a prescription for antimuscarinics during the study period, was 35.1% (2,760 of 7,858). Of 5,098 patients who refilled a prescription 1,305 changed the medication or dose at least once for a medication switch rate of 25.6%. The overall median medication possession ratio, defined as the total days of medication dispensed except for the last refill divided by the number of days between the first dispense date and the last refill date, was 0.82 in all cases. Men had a significantly higher median medication possession ratio than women (0.86 vs 0.81, p <0.001). Of patients who obtained at least 1 refill women remained on medication longer than men (median 606 vs 547 days, p = 0.01). Patients on tolterodine extended release had a higher medication nonpersistence rate than those on oxybutynin immediate release (0.89 vs 0.68, p <0.01). There was no difference between extended release medications. Conclusions: In a health care system in which patients do not pay for medications 35% of patients did not refill a prescription for overactive bladder medication, similar to previous reports. However, other measures of medication compliance were higher than those published previously in systems with copays. 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Google Scholar 8 : Persistence and adherence of medications for chronic overactive bladder/urinary incontinence in the California Medicaid program. Value Health2005; 8: 495. Google Scholar 9 : Persistence with overactive bladder pharmacotherapy in a Medicaid population. Am J Manag Care2005; 11: S121. Google Scholar 10 : Persistence, adherence, and switch rates among extended-release and immediate-release overactive bladder medications in a regional managed care plan. J Manag Care Pharm2008; 14: 291. Google Scholar 11 : Predictors of medication adherence and associated health care costs in an older population with overactive bladder syndrome: a longitudinal cohort study. J Urol2006; 175: 1067. Link, Google Scholar 12 : Immediate-release oxybutynin versus tolterodine in detrusor overactivity: a population analysis. Pharmacotherapy2000; 20: 470. 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Google Scholar © 2010 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited byChapple C, Abrams P, Andersson K, Radziszewski P, Masuda T, Small M, Kuwayama T and Deacon S (2018) Phase II Study on the Efficacy and Safety of the EP1 Receptor Antagonist ONO-8539 for Nonneurogenic Overactive Bladder SyndromeJournal of Urology, VOL. 191, NO. 1, (253-260), Online publication date: 1-Jan-2014.Veenboer P and Bosch J (2018) Long-Term Adherence to Antimuscarinic Therapy in Everyday Practice: A Systematic ReviewJournal of Urology, VOL. 191, NO. 4, (1003-1008), Online publication date: 1-Apr-2014.Wein A and Griebling T (2018) Re: Persistence with Prescribed Antimuscarinic Therapy for Overactive Bladder: A UK ExperienceJournal of Urology, VOL. 190, NO. 4, (1328-1330), Online publication date: 1-Oct-2013.Related articlesJournal of Urology22 Jan 2010Adipose Derived Stem Cells Ameliorate Hyperlipidemia Associated Detrusor Overactivity in a Rat Model Volume 183Issue 3March 2010Page: 1077-1081 Advertisement Copyright & Permissions© 2010 by American Urological Association Education and Research, Inc.Keywordsurinary bladdermilitary personnelmuscarinic antagonistsoveractivedelivery of health caremedication adherenceMetricsAuthor Information Christine L.G. Sears National Capitol Consortium Fellowship in Female Pelvic Medicine and Reconstruction, Walter Reed Army Medical Center, Washington, D. C. Department of Urology, National Naval Medical Center, Bethesda, Maryland More articles by this author Christa Lewis Uniformed Services University of the Health Sciences, Bethesda, Maryland More articles by this author Kathleen Noel National Capitol Consortium Fellowship in Female Pelvic Medicine and Reconstruction, Walter Reed Army Medical Center, Washington, D. C. More articles by this author Todd S. Albright National Capitol Consortium Fellowship in Female Pelvic Medicine and Reconstruction, Walter Reed Army Medical Center, Washington, D. C. Uniformed Services University of the Health Sciences, Bethesda, Maryland More articles by this author John R. Fischer National Capitol Consortium Fellowship in Female Pelvic Medicine and Reconstruction, Walter Reed Army Medical Center, Washington, D. C. Uniformed Services University of the Health Sciences, Bethesda, Maryland More articles by this author Expand All Advertisement PDF downloadLoading ..." @default.
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