Obstet Gynecol Sci.  2015 Nov;58(6):507-513. 10.5468/ogs.2015.58.6.507.

Factors affecting medication discontinuation in patients with overactive bladder symptoms

• Shim EJ
• Yoo EH
• Kim YM
• Kim D

• KMID: 2314068
• DOI: http://doi.org/10.5468/ogs.2015.58.6.507

Abstract

OBJECTIVE
To find out the factors affecting medication discontinuation in patients with overactive bladder (OAB) symptoms.
METHODS
The clinical data of 125 patients with OAB symptoms who had taken antimuscarinics and behavioral therapy were retrospectively reviewed. Antimuscarinics related outcomes were evaluated by an independent observer with telephone interview. All patients were asked about duration of medication and reason of continuation or discontinuation of antimuscarinics. To determine pre-treatment factors predicting self-report discontinuation of antimuscarinics, variables of only those with P-values <0.25 on the univariate analysis were included in the Cox proportional hazard modeling.
RESULTS
Mean follow-up was 39.6 months and the proportion of discontinuation of antimuscarinics was 60.0% (75/125). The mean duration of medication was 21.2 months in the continuation group and 3.3 months in the discontinuation group. The reasons of discontinuation of antimuscarinics were improved OAB symptoms (46.7%), tolerable OAB symptoms (33.3%), no change of OAB symptoms (1.3%), side-effects (8.0%) and no desire to take long-term medication (10.7%). The variables affecting remaining cumulative probability of antimuscarinics were age, history of anti-incontinence surgery or vaginal surgery, and having stress predominant urinary incontinence on urodynamic study.
CONCLUSION
The lower rate of cumulative continuation of antimuscarinics encourages us to give a more detailed counseling and education to the patients with OAB symptoms before prescription. And explorations about newer agent and non-pharmacologic treatment with good efficacy and lower side-effects are needed.

Keyword

Discontinuation; Muscarinic antagonists; Urinary bladder, overactive

MeSH Terms

Counseling
Education
Follow-Up Studies
Humans
Interviews as Topic
Muscarinic Antagonists
Prescriptions
Proportional Hazards Models
Retrospective Studies
Urinary Bladder, Overactive*
Urinary Incontinence
Urodynamics
Muscarinic Antagonists

Figure

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  Fig. 1 Cumulative probability of remaining on the antimuscarinics according to age.

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