Validation of a simple patient questionnaire to assist self-detection of overactive bladder A study in general practice

Objective – To develop and validate a simple patient questionnaire for the detection of overactive bladder (OAB).

Design – An open, non-randomized multicentre study.

Setting – A pilot study (n=133) was conducted to bring forward five questions from initially 14 questions, for detection of OAB. These five questions were subject to further validation in the main study (n=520).

Subjects – 531 adults responding to a newspaper advertisement regarding symptoms of OAB and patients seeing a physician for other reasons were attending 28 general practitioners.

Main outcome measures – Agreement rate, sensitivity, and specificity.

Results – The agreement rate between the patients’ own diagnosis based on the patient questionnaire, and the physicians’ diagnosis based on medical history, urine analysis, and micturition chart, was 0.78 (κ=0.89). Sensitivity and specificity were 0.98 and 0.90, respectively.

Conclusion – The validated questionnaire may become a useful tool to decide whether a patient has overactive bladder. The questionnaire corresponds well with the physicians’ diagnosis.     

Coping strategies and health care-seeking behavior in a US national sample of adults with symptoms suggestive of overactive bladder

BACKGROUND: Although millions of individuals have symptoms suggestive of overactive bladder (OAB), few ever seek or receive medical treatment for their condition. Objective: The purpose of this study was to describe coping strategies and health care-seeking behavior in a community-based sample of adults with symptoms suggestive of OAB. METHODS: A cross-sectional household telephone survey of an age- and sex-stratified sample of adults was conducted. The survey consisted of general health-related questions as well as questions related to OAB symptoms. A total of 4896 adults completed the interview Respondents were considered to have OAB if they reported > or = 1 symptom of urinary urgency, frequency, or urge incontinence. A follow-up questionnaire was then mailed to a subsample of the telephone interview respondents. The mailed questionnaire contained questions related to type and severity of OAB symptoms, coping strategies, medical care/treatment, feelings/beliefs about OAB, and quality of life. Half of the phone respondents with urinary incontinence (n = 638) and a random sample of all other phone respondents received the mailed questionnaire (n = 873); 1,034 questionnaires were returned. RESULTS: Of the respondents with OAB, 69.6% tried > or = 1 nonmedical coping strategy. Respondents with incontinent OAB were significantly more likely than those with continent OAB or those with no OAB (controls) to use nonmedical coping strategies (incontinent OAB, 76.1%; continent OAB, 59.0%; controls, 31.9%; P < 0.001). Fewer than half of the respondents with OAB (43.5%) had spoken with a provider about OAB in the previous 12 months. Medical consultation was associated with sex, type and severity of OAB, number of nonmedical coping strategies tried, number of OAB information sources consulted, inclination to try new OAB medications, and feelings/beliefs about OAB. In 90% of patient-provider discussions about OAB, the patient initiated the topic. CONCLUSIONS: Individuals manage symptoms suggestive of OAB primarily by using nonmedical coping strategies rather than consulting health care providers. Results of this study support the need for improved clinical recognition of OAB and increased patient-provider communication about this condition.     

Validation of a 3-item OAB awareness tool

Aim: The purpose of this study was to validate a short awareness tool to assist patients in identifying if they have bothersome overactive bladder (OAB) symptoms. Methods: This secondary analysis study utilised data from a cross‐sectional study of adult patients presenting for primary care visits. Patients completed an 8‐item OAB screener. The clinician probed for urinary frequency, urgency, nocturia and urgency urinary incontinence. If the patient screened positive or reported the presence of at least one OAB symptom, additional questions were asked regarding lifestyle and coping issues. The clinician then diagnosed the patient as having No OAB, Possible OAB, or Probable OAB. Multivariate logistic regressions were performed to assess the feasibility of deriving a shorter screener to raise awareness of OAB among primary care patients. Results: The 1,260 patients in this study were 51.6 ± 17.0 years old; 62% were women; and most (89%) were Caucasian. Clinicians diagnosed 12.1% of patients with Probable OAB, 19.7% with Possible OAB and 68.3% with No OAB. The logistic regression models were performed with OAB clinical diagnosis as the dependent variable comparing No OAB versus Probable OAB. Three items which included the symptoms of urinary frequency, urinary urgency and urine loss associated with a strong desire to urinate performed well as an awareness tool. A cut‐point of four provided the most appropriate sensitivity (82%) and specificity (91%) when identifying Probable OAB and yielded adequate model fit. The final 3‐item OAB Awareness Tool (OAB‐V3) is gender neutral. Conclusion: The 3‐item OAB Awareness Tool (OAB‐V3) correctly identified patients with symptoms of OAB with high sensitivity and specificity and can be used as a conversation starter for patients with symptoms of OAB.     

生物反馈治疗联合康复训练在中年女性膀胱过度活动症患者中的应用效果

目的 探讨生物反馈治疗联合康复训练在中年女性膀胱过度活动症(OAB)患者中的应用效果.方法 选取医院2015年2月—2017年8月收治的中年女性OAB患者96例为研究对象,将患者按照组间年龄、病程、膀胱过度活动症患者症状评估表(OABSS)评分匹配的原则分为对照组和观察组,每组48例.对照组采取常规护理及药物治疗,观察...     

Symptom bother and health-related quality of life outcomes following solifenacin treatment for overactive bladder: the VESIcare Open-Label Trial (VOLT)

BACKGROUND: Most clinical trials designed to evaluate overactive bladder (OAB) syndrome treatments have focused on measuring micturition variables from bladder diaries. However, although diaries help physicians assess symptoms objectively, they lack information on patients' subjective experience of OAB symptoms and the effects of treatment. OBJECTIVE: The objective of this study was to assess patients' perceptions of improvements in symptom bother and health-related quality of life (HRQOL) with solifenacin succinate 5- and 10-mg treatments in patients with OAB. METHODS: VOLT (VESIcare Open-Label Trial) was a prospective, flexible-dosing trial performed at 207 centers in the United States. Ambulatory adult (aged > or = 18 years) men and women with an established diagnosis of OAB (urgency, urge urinary incontinence, frequency, and/or nocturia for > or = 3 months) and who provided a sterile urine sample received solifenacin QD for 12 weeks. Initially, all patients received 5 mg/d, with the option of adjustment to 10 mg/d at 4 and 8 weeks. Effectiveness was assessed using the Patient Perception of Bladder Condition (PPBC) scale, a visual analog scale (VAS) for the degree of bother caused by individual OAB symptoms, and the overactive bladder questionnaire (OAB-q). Assessments were performed at study initiation and study end or study termination. Adverse events (AEs) were assessed throughout. RESULTS: Patients (N = 2225) were enrolled between June 2004 and April 2005. Patients with baseline data (n = 2205) had a mean (SD) age of 59.7 (14.4) years; most patients were women (1813 [82.2%]) and white (1761 [79.9%]). Of the total patients enrolled, 1743 (78.3%) completed all 12 weeks of the study. After 12 weeks of solifenacin treatment, improvement was observed in the mean values of patient-reported perception of bladder condition. Significant change was observed on the PPBC scale from the mean baseline value to study end (4.4 vs 2.9; P < 0.001). All subscales of HRQOL significantly improved on the OAB-q score (mean changes, 14.7 to 29.6; all, P < 0.001). On the VAS, there was a significant reduction in the degree of bother associated with urgency, urge urinary incontinence, frequency, and/or nocturia (mean changes in VAS ratings, -36.7 to -41.8; all, P < 0.001 vs baseline). Solifenacin was well tolerated in most patients. Treatment-emergent AEs were reported by 1321 (59.4%) patients. Most reported AEs were anticholinergic in nature and of mild to moderate severity: dry mouth, 477 (21.4%); constipation, 295 (13.3%); headache, 76 (3.4%); blurred vision, 57 (2.6%); nausea, 39 (1.8%); dyspepsia, 34 (1.5%); and dry eye, 29 (1.3%). Two hundred sixteen (9.7%) patients discontinued treatment due to AEs. CONCLUSION: Flexibly dosed solifenacin 5 and 10 mg QD was associated with reductions in patient-reported OAB symptom bother and improvements in patients' perception of bladder condition and HRQOL.     

Quantitative analysis of the levels of expression of muscarinic receptor subtype RNA in the detrusor muscle of patients with overactive bladder.

INTRODUCTION: Antimuscarinic drugs have frequently been used for the treatment for patients with an overactive bladder (OAB) and there have been many studies on the distribution of muscarinic receptor subtypes in the bladder. However, the distribution of muscarinic receptor subtypes in OAB patients has not been well investigated. In this study we investigated the distribution of muscarinic receptor subtypes with mRNA and protein expressions in patients with and without OAB, and investigated both the dome and trigone area. METHODS: Samples of bladder smooth muscle were obtained from 10 individuals, five patients with OAB and a non-OAB group consisting of five patients who received radical cystectomy. RESULTS: The M2 receptor was predominant, but there was no significant difference in the level of M2 expression between the groups in the dome area. M5 expression in the dome area was significantly higher in the OAB group than in the non-OAB group. In the trigone area, the level of M2 mRNA expression was the highest in the non-OAB group, and was significantly lower in the OAB group. The levels of M1 and M5 mRNA expression were also observed in samples obtained from the trigone area. CONCLUSION: The multiformity of the muscarinic receptor subtypes in human bladder smooth muscle was confirmed, and our results suggest that the efficacy of a given pharmacologic therapy differs from patient to patient.     

Patient-reported goal achievement after antimuscarinic treatment in patients with overactive bladder symptoms

Aim: Standardised traditional outcome measures may fail to address factors that are important to patients and address irrelevant factors. Aim of this study was to assess patient‐reported goals and goal achievement (GA) in the antimuscarinic treatment for overactive bladder (OAB) patients. Methods: Men and women aged ≥ 18 years with OAB symptoms were eligible for the study. Treatment began with a dose of 10 mg oxybutynin, to be increased if necessary to 30 mg. Before treatment, each patient’s primary treatment goal was identified. After 12‐week treatment, patients reported GA using a Likert scale from 0 (no achievement) to 5 (complete achievement). Successful achievement was defined as a score of 4 or 5. Traditional outcome measures including voiding diaries, the OAB questionnaire short form, patient perception of bladder condition, and treatment benefit and satisfaction were assessed. Baseline characteristics affecting GA and the correlation between GA and traditional outcome measures were evaluated. Results: A total of 303 goals were identified from 303 patients (51 men, 252 women). Of those, 72.3% addressed symptom relief and frequency as the most common target symptom. Other goals addressed were improving quality of life (13.5%) and eliminating coping behaviours (14.2%). After treatment, 42% had a successful GA with a median score of 3 (interquartile range; 2–4). Age had a negative effect on GA. Goal achievement was the outcome measure most correlated with treatment benefit and satisfaction. Discussion and Conclusions: Goal achievement can be a valuable outcome measure in OAB patients, addressing individual treatment goals and reflecting treatment benefit and patient satisfaction.     

Relationships between improvements in symptoms and patient assessments of bladder condition, symptom bother and health-related quality of life in patients with overactive bladder treated with tolterodine

Aims: Relationships were evaluated between treatment‐related improvements in overactive bladder (OAB) symptoms as recorded in bladder diaries and patient‐reported symptom bother, bladder‐related problems and health‐related quality of life (HRQL). Methods: A post hoc analysis was performed on data from patients with OAB (n = 863) enrolled in a 12‐week open‐label trial of tolterodine extended release (ER) in a primary care setting. At baseline and week 12, patients recorded every micturition, urgency episode and urgency urinary incontinence episode in 3‐day bladder diaries. Patients also completed the Overactive Bladder Questionnaire (OAB‐q) and Patient Perception of Bladder Condition (PPBC). Relationships between week 12 changes in bladder diary variables and OAB‐q and PPBC scores were evaluated using Spearman correlations. Results: By week 12, tolterodine ER‐related improvements in all bladder diary variables were significantly correlated with improvements on the PPBC (r = 0.26–0.36; p < 0.001), OAB‐q Symptom Bother scale (r = 0.30–0.51; p < 0.001), and all OAB‐q HRQL domains (r = ?0.24 to ?0.42; p < 0.001), although the correlations were generally small to moderate in size. Improvements on the PPBC were also significantly correlated with improvements on the OAB‐q Symptom Bother scale (r = 0.63; p < 0.001) and all HRQL domains (r = ?0.40 to ?0.59; p < 0.001). Conclusions: Tolterodine ER‐related improvements in OAB symptoms (assessed by diary variables) and patients’ perceptions of the changes in symptom bother, bladder‐related problems and HRQL (assessed by PPBC and OAB‐q) were significantly correlated. The OAB‐q and the PPBC provide a relevant and important patient perspective for OAB treatment evaluation.     

Validation study of the Self‐Assessment Goal Achievement (SAGA) questionnaire for lower urinary tract symptoms

Background:  Patients’ treatment goals for overactive bladder (OAB) and other lower urinary tract symptoms (LUTS) may not be aligned with their healthcare provider’s goals. Successful management of OAB symptoms is improved by individualised treatment plans with attainable treatment goals. Goal attainment setting may facilitate patient–provider interaction and the development of a personalised treatment plan based on realistic, individual goals, thereby increasing patient satisfaction and therapeutic outcomes. The purpose of this study was to validate the utility of the Self‐Assessment Goal Achievement (SAGA) questionnaire for LUTS in helping patients identify and achieve realistic treatment goals. Methods:  The 2‐module SAGA questionnaire consists of nine prespecified (fixed) items and five open‐ended items for goal identification and ranking (baseline module) and goal achievement rating (follow‐up module). Adult patients in the United States (n = 104) seeking treatment for LUTS, including symptoms of OAB, completed the SAGA baseline module, micturition diary, other patient‐reported outcome measures (PROs), and discussed their urinary goals with a clinician at baseline. The SAGA follow‐up module was completed 2–4 months later. SAGA was validated based on analyses of face, concurrent, known‐groups, and convergent validity and item distribution. Results:  Among the nine fixed goals of SAGA, four were ranked as very important by > 50% of patients (i.e. reduce night‐time frequency, daytime frequency, urine leakage, urgency). Most patients did not change the importance level of their goals after discussion with their healthcare provider. Pearson correlations between SAGA, diary variables and PRO scores were generally of low to moderate strength. The global mean (SD) follow‐up SAGA T‐score was 32.54 (12.54), indicating that overall goal attainment was not achieved after 3 months. The goal attainment score was significantly different between groups differing in symptom severity, health‐related quality of life, bladder control and continence status. Conclusions:  The results support the validity of SAGA as a measure of patients’ goals and goal achievement for the treatment of LUTS, including symptoms of OAB. SAGA may improve healthcare provider–patient interactions and treatment outcomes in clinical practice.     

Satisfaction with tolterodine: assessing symptom-specific patient-reported goal achievement in the treatment of overactive bladder in female patients (STARGATE study)

AIMS: Open-label study to evaluate the effect of tolterodine extended-release (ER) on symptom-specific patient-reported goal achievement (PGA) of overactive bladder (OAB) symptoms in females. METHODS: Eligible patients who had frequency >or= 8 and urgency >or= 2 episodes per 24 h with or without urgency incontinence were treated with 12-week tolterodine ER (4 mg once daily). Primary end-point was the rate of PGA by a visual analogue scale compared with initial expectation with treatment. At baseline, patients were asked to set their personal goals for each OAB symptom with treatment. Secondary efficacy variables were changes in symptom severity, voiding diary and patient perception of bladder condition (PPBC), global impression of improvement (GII), and willingness to continue treatment. RESULTS: A total of 56 patients were entered. The median rate of symptom-specific PGA and reductions in symptom severity were for frequency (60%, 45%), episodes of urgency 60%, 55%), urge incontinence (80%, 71%), nocturia (50%, 52%) and tenesmus (30%, 26%) after 12 weeks treatment. There was a significant improvement in all OAB symptoms in voiding diary. Thirty-five patients (62.5%) experienced an improvement of >or= 2 points in PPBC. Thirty (53.6%) and 22 (39.3%) of patients reported much and little improvement of their symptoms in GII. A total of 41 (73.2%) patients wanted to continue taking the medication at the end of the study. CONCLUSIONS: Most OAB patients reported improvement of their OAB symptoms with 12-week tolterodine ER 4 mg treatment. There was a significant achievement of symptom-specific goal on the key OAB symptoms. But, PGA did not correlate with objective outcomes.     

Validation of an overactive bladder awareness tool for use in primary care settings

Overactive bladder (OAB)—a syndrome characterized by urinary urgency, with or without urge incontinence, urinary frequency and nocturia—is estimated to affect 10% to 20% of the US and European populations. This study was carried out to validate a patient-administered screening awareness tool to identify patients with bothersome OAB symptoms. Patients were recruited from 12 primary care and 1 gynecology practice during regularly scheduled appointments. Enrollees completed an 8-item questionnaire assessing the amount of “bother” they associated with OAB symptoms. Clinicians then asked the patients 4 questions regarding urinary frequency, urgency, nocturia, and incontinence. If the screening was positive for symptoms of OAB or if the patient provided positive responses to the urinary symptom questions, the clinician asked additional questions regarding lifestyle and coping behaviors. The clinician then diagnosed the patient, placing him or her in the “No OAB,” “Possible OAB,” or “Probable OAB” category. Multivariable logistic regressions controlling for age and sex were performed to assess the applicability of the tool for identifying patients with OAB. A total of 1299 patients were enrolled, and 1260 provided complete data. Patients were aged 51.6±17.0 years, 62% were female, most (89%) were Caucasian, 22% experienced urinary urgency, and 18% experienced urge incontinence. The prevalence of Probable OAB was 12%. The c-index of the model identifying patients with a diagnosis of Probable OAB was 0.96, with a sensitivity and specificity of 98.0 and 82.7. For OAB-V8 scores ≥8, the odds ratio for Probable OAB was 95.7 (95% Cl: 29.3; 312.4). The OAB-V8 performed well in helping clinicians identify patients with bothersome OAB symptoms in a primary care setting and will assist clinicians in identifying patients who may benefit from treatment.     

Relationships between symptoms, symptom bother, and health-related quality of life in patients with overactive bladder taking solifenacin or placebo in the VIBRANT study

Aims: Studies of antimuscarinics for overactive bladder (OAB) typically use objective and subjective measures to assess efficacy, as each provides unique information about patient outcome. We evaluated the relationships between changes in diary‐documented OAB symptoms and other patient‐reported outcome (PRO) measures. Methods: In VIBRANT, OAB patients received solifenacin (5/10 mg) or placebo for 12 weeks. During the study, patients completed 3‐day bladder diaries and other generic and disease‐specific PRO measures. Data from both treatment groups were combined (n = 738). Categorical changes in diary variables were compared with changes in PRO measures. Partial correlations controlling for treatment and Spearman correlations were also calculated. Results: Categorical improvements in diary variables were significantly associated with greater improvements in PRO measures. Pair‐wise comparisons showed that patients with major symptomatic improvements had significantly greater improvements on PROs vs. those with some or no improvement. Odds ratios ranged from 1.52 to 4.09 (p ≤ 0.002). Linear relationships between changes in PRO measures and diary variables were low to moderate but statistically significant (p < 0.001). Partial correlations were highest for diary variables and OAB‐Questionnaire Symptom Bother. Spearman correlations ranged from 0.170 to 0.450 (p < 0.001). Conclusions: In patients with OAB, changes in objectively measured symptoms of urgency, incontinence and frequency showed low‐to‐moderate correlations to changes in PRO measures. While providing evidence for similar change patterns in symptoms and patient perceptions, correlations were not high, lending support to the concept that in OAB clinical trials, both bladder diaries and PRO measures are important independent measures of efficacy.     

Efficacy of solifenacin for overactive bladder symptoms, symptom bother, and health-related quality of life in patients by duration of self-reported symptoms: a secondary analysis of the VIBRANT study

In this post-hoc analysis of data from patients with overactive bladder (OAB) in VIBRANT patients receiving solifenacin showed statistically significantly greater improvement versus placebo in most outcome measures regardless of OAB symptom duration (less than five years and five years or longer).     

排尿行为认知干预改善膀胱过度活动症患者结局的随机对照试验

目的探讨基于健康信念模式的排尿行为认知干预应用于膀胱过度活动症(overactive bladder,OAB)患者的效果。方法 2014年5-8月,便利抽样选取济南市两所三级甲等医院内分泌科门诊接受规律随访的糖尿病合并OAB的患者104例,随机隐匿分为试验组51例和对照组53例。对照组给予常规的健康教育手册,试验组在此基础上给予连续6周的排尿行为认知干预。比较两组患者在干预前后的排尿行为、膀胱症状和生活质量变化情况。结果干预后试验组患者的排尿行为、膀胱症状和生活质量均优于对照组(均P0.05),且试验组患者干预前后指标的改变量也明显高于对照组(P0.05)。结论基于健康信念模式的排尿行为认知干预,可以改进OAB患者的排尿行为,改善膀胱症状,提高其生活质量。     

The assessment of quality of life in female Turkish patients with overactive bladder

The objective of this study was to examine the quality of life in female Turkish patients with overactive bladder (OAB). The investigation was conducted as a cross-sectional study between January and April 2010. Two hundred eighty female patients responded to the Overactive Bladder Validated Eight-Question Screener, the OAB disease-specific health-related quality-of-life scale (OAB questionnaire (OAB-q)) and the general quality-of-life scale EuroQol Five-Dimensional Questionnaire (EQ-5D) for the study. Of the 280 patients, 38.9% was classified as having OAB. The mean age was 47.0 ± 8.7. All of the quality-of-life domains (coping, concern, sleep and social) and OAB-q total scores in women with OAB were significantly worse than in women without OAB (P < 0.001 for all). Similarly, the EQ-5D(index) and EQ-5D(VAS) scores for women with OAB were significantly worse than for women without OAB (P < 0.001 and P = 0.006, respectively). OAB-q and EQ-5D(index) scores in menopausal women were significantly lower than non-menopausal women (P < 0.05) in patients with OAB. In conclusion, OAB negatively affects quality of life in Turkish women. However, many women's quality of life can be improved if the patients seek medical treatment. Thus, nurses should encourage the patients to seek medical support in order to cope with health-related quality-of-life problems.     

Psychometric evaluation of the medical outcomes study-sleep scale in persons with overactive bladder

BACKGROUND: The Medical Outcomes Study-Sleep Scale (MOS-SS) is a commonly used self-reported instrument for assessing key constructs of sleep quality and quantity. Even though the MOS-SS has successfully undergone previous validation studies in the general population, it has not been evaluated in patients with overactive bladder (OAB). OBJECTIVE: The aim of this study is to evaluate the applicability of the MOS-SS to persons with a diagnosis of OAB. METHODS: This study was a follow-up to a national nested case-control survey designed to provide estimates of the prevalence of OAB in the United States. OAB patients (N = 363) who consented to participate were mailed a postal survey to assess OAB symptoms and health-related quality of life. Analyses were then undertaken to assess the psychometric properties of the MOS-SS in this OAB sample. Psychometric evaluation of the MOS-SS included construct validity, internal consistency reliability, correlation between domains, floor/ceiling effects, and an examination of the factor structure. Results were compared with the original validation population of the MOS-SS by . RESULTS: Internal consistency, correlations between domains, and floor/ceiling effects were generally consistent with results from the original validation study. Factor loadings of the MOS-SS items, as well as tests of construct validity, were similar between persons with OAB and individuals in the original validation population. CONCLUSION: Psychometric evaluation conducted in this study supports the use of the MOS-SS instrument to assess sleep problems among persons with OAB.     

A multicenter,prospective, open-label study of tolterodine extended-release 4 mg for overactive bladder: the speed of onset of therapeutic assessment trial (STAT)

BACKGROUND: Antimuscarinic agents are the primary treatment for overactive bladder (OAB), but there is a lack of information regarding when maximum symptom relief and maximum perceived patient benefit occur. OBJECTIVE: This study assessed the speed of onset of therapeutic benefit with tolterodine extended-release (ER) 4 mg. METHODS: This 12-week, multicenter, prospective, open-label study enrolled patients with OAB who either had received no previous pharmacologic treatment for OAB (drug naive) or were receiving such treatment at enrollment (previously treated). Efficacy was assessed at 1, 4, and 12 weeks using a micturition diary and measures of patients' and physicians' perceptions of improvement. Safety was assessed in terms of adverse events and study withdrawals. RESULTS: The intent-to-treat population included 1138 patients (302 men, 836 women; 88.4% white; age range, 18-91 years), 735 drug naive and 403 receiving treatment for OAB at enrollment. After 1 week, tolterodine ER 4 mg had produced a significant improvement in all efficacy variables in both groups of patients (P < 0.01); 72% of the maximum effect on urge incontinence was observed in both groups; and 84.7% of drug-naive patients and 83.6% of previously treated patients perceived a benefit from treatment. After 4 weeks, drug-naive and previously treated patients reported a respective 93% and 100% of the maximum effect on episodes of urge incontinence. Tolterodine was well tolerated, with dry mouth (mostly mild) the most commonly reported adverse event (15.5% in each group). The 330 (81.9%) patients who had reported unacceptable efficacy and the 87 (21.6%) patients who had reported unacceptable tolerability of previous OAB treatment responded favorably to tolterodine ER 4 mg. CONCLUSIONS: Tolterodine ER 4 mg was effective and well tolerated in both drug-naive and previously treated patients with OAB. More than 80% of patients reported benefit from treatment after 1 week, but maximum symptom relief was achieved with longer treatment.     

Symptom-specific efficacy of tolterodine extended release in patients with overactive bladder: the IMPACT trial

We evaluated the efficacy of tolterodine extended release (ER) for patients' most bothersome overactive bladder (OAB) symptom in a primary care setting. Patients with OAB symptoms for >or=3 months received tolterodine ER (4 mg q.d.) for 12 weeks. Among incontinent patients (n = 772), the most bothersome OAB symptoms were daytime frequency (28%), urgency urinary incontinence (UUI; 27%), nocturnal frequency (26%) and urgency (19%); among continent patients (n = 91), they were daytime frequency (47%), nocturnal frequency (42%) and urgency (10%). Sixty-nine per cent of patients had one or more comorbid conditions. By week 12, there were significant reductions in patients' most bothersome symptom: -80% for UUI, -78% for urgency episodes, -40% for nocturnal frequency and -30% for daytime frequency (p < 0.0001). The most common adverse events were dry mouth (10%) and constipation (4%). In primary care practice, bothersome OAB symptoms can be effectively and safely treated with tolterodine ER, even in patients with comorbid conditions.     

老年糖尿病膀胱过度活动症患者疾病感知现状及其与生活质量的相关性

目的 探讨老年糖尿病膀胱过度活动症(overactive bladder,OAB)患者疾病感知现状,并分析其与生活质量的相关性.方法 2020年5月至2021年4月,便利抽样法选取镇江市某三级甲等医院208例老年糖尿病OAB患者为研究对象.采用一般资料调查表、膀胱过度活动症症状评分量表、简化版疾病感知问卷、膀胱过度活动...