Degree of satisfaction of patients continuing overactive bladder treatment with mirabegron
Authors:
K. Švabík 1,9; J. Mašata 1; J. Krhut 2,9; R. Zachoval 4,9; T. Hanuš 3,9; M. Halaška 5,9; L. Horčička 6,9; L. Krofta 7,9; M. Hanáková 8; A. Martan 1,9
Authors‘ workplace:
Gynekologicko-porodnická klinika VFN a 1. LF UK, Praha, přednosta prof. MUDr. A. Martan, DrSc.
1; Urologické oddělení FN, Ostrava, přednosta doc. MUDr. J. Krhut, Ph. D.
2; Urologická klinika VFN a 1. LF UK, Praha, přednosta prof. MUDr. T. Hanuš, DrSc.
3; Urologické oddělení FTN Krč, Praha, přednosta doc. MUDr. R. Zachoval, Ph. D., MBA
4; Gynekologicko-porodnická klinika 1. LF UK a Nemocnice Na Bulovce, Praha
přednosta prof. MUDr. M. Halaška, DrSc.
5; Nestátní zdravotnické zařízení GONA, s. r. o., gynekologie, Praha, vedoucí lékař MUDr. L. Horčička
6; Ústav pro péči o matku a dítě, Praha, ředitel doc. MUDr. J. Feyereisl, CSc.
7; Uromeda, s. r. o., Brno, vedoucí lékařka MUDr. M. Hanáková
8; EUNI Inkoboard – www. euni. cz
9
Published in:
Ceska Gynekol 2017; 82(1): 48-52
Overview
Objective:
Overactive bladder syndrome is chronic disease with high prevalence rate (9–42%). This syndrome requires long term therapy, but the treatment persistence is after 3 months over all 26% with further decline in one-year period as low as 18.5%. Main reasons for stopping the treatment are low efficacy, ‘the medication didn’t work as expected’ and side effects. How much satisfied are patients with mirabegron persisting on its treatment? To answer this question, we provided secondary analysis of multicentre follow-up study of patients on mirabegron. We compared subjective and objective parameters between patients continuing mirabegron treatment and those who discontinued the medication.
Design:
Secondary analysis multicentre prospective follow-up.
Settings:
Ob/Gyn department First Faculty of Medicine, Charles University and General University Hospital, Prague.
Methods:
It is secondary analysis of multicentre prospective study following patients with mirabegron 50 mg treatment. We have analysed objective data from micturition diary and subjective data using visual analogue scales (UB-VAS – urgency bother visual analogue scale, and TS-VAS – treatment satisfaction visual analogue scale) and compared data between the group of patients continuing mirabegron treatment and patients who stopped the medication during the study.
Results:
We included 206 patients (176 women, 30 men) with diagnosis of overactive bladder. Patients continuing the treatment (group n1) had baseline UB-VAS 70.1 vs. 75.0 (p = n.s.) in patients who stopped the medication during the follow-up period (group n2). Baseline episodes of severe urgency and urge incontinence where n1 – 5.1 vs. n2 – 6.2 (p = n.s.). Six months’ urgency bother score UB-VAS was n1 – 32.4 vs. n2 – 58.9 (p < 0,001). Treatment satisfaction TS-VAS was n1 – 80.3 vs. n2 – 57.7 (p < 0,001). Number of severe urgencies with or without urge incontinence was after 6 months n1 – 2.1 vs. n2 – 3.3 (p = n.s.), lower in group continuing the treatment. When comparing the data between patients stopping the medication for reason of low efficacy (group s1) with patients stopping for other reasons (group s2) UB-VAS bas: s1 - 68.5 vs. s2 – 43.9 (p = 0.001); TS VAS s1 – 45.1 vs. s2 – 58.4 (p = n.s.) and number of severe urgency with or without incontinence s1 – 5.9 vs. s2 – 3.2 (p = 0.009).
Conclusion:
Our data shows that patients expectation on treatment with mirabegron is not low. Patients accept treatment either without side effects or with decrease of severe urgency with or without urge incontinence around 50%. Regardless the reason the patients continuing the treatment scale treatment satisfaction – TS-VAS over 70 points.
Keywords:
persistence, mirabegron, overactive bladder, treatment efficacy
Sources
1. Benner, JS., Nichol, MB., Rovner, ES., et al. Patient-reported reasons for discontinuing overactive bladder medication. BJU Int, 2010, 105, p. 1276–1282.
2. Bridgeman, MB., Friia, NJ., Taft, C., Shah, M. Mirabegron: beta3-adrenergic receptor agonist for the treatment of overactive bladder. Ann Pharmacother, 2013, 47, p. 1029–1038.
3. Brubaker, L., Fanning, K., Goldberg, EL., et al. Predictors of discontinuing overactive bladder medications. BJU Int, 2010, 105, p. 1283–1290.
4. Duckett, J. Balachandran, A. Tolerability and persistence in a large, prospective case series of women prescribed mirabegron. Int Urogynecol J, 2016.
5. Haylen, BT., de Ridder, D., Freeman, RM., et al. A. International Urogynecological, and S. International Continence, An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for female pelvic floor dysfunction. Neurourol Urodyn, 2010, 29, p. 4–20.
6. Kim, TH., Lee, KS. Persistence and compliance with medication management in the treatment of overactive bladder. Investig Clin Urol, 2016, 57, p. 84–93.
7. Martan, A., Horcicka, L., Hanus, T., et al. [Prevalence of women with overactive bladders in the Czech Republic]. Ces Gynek, 2011, 76, s. 144–150.
8. Martan, A., Krhut, J., Masata, J., et al. Persistence in the treatment of OAB with mirabegron in a clinical multicenter clinical study. Int Urogynecol J Pelvic Floor Dysfunct, 2016, p. S24–S25.
9. Sackett, DL. The hypertensive patient: 5. Compliance with therapy. Can Med Assoc J, 1979, 121, p. 259–261.
10. Svabik, K., Krhut, J., Finsterle, V., Martan, A. Perzistence užívání léčby hyperaktivního močového měchýře v České republice. Čes Gynek, 2013, 78, s. 252–256.
11. Vermeire, E., Hearnshaw, H., Van Royen, P., Denekens, J. Patient adherence to treatment: three decades of research. A comprehensive review. J Clin Pharm Ther, 2001, 26, p. 331–342.
12. Wagg, A., Compion, G., Fahey, A., Siddiqui, E. Persistence with prescribed antimuscarinic therapy for overactive bladder: a UK experience. BJU Int, 2012.
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