OAB is common and its prevalence can vary widely depending on the patient population and disease definition, affecting 7–27% of men and 9–43% of women. Overactive bladder (OAB) is defined by the International Continence Society (ICS) as a symptom syndrome defined by urinary urgency, frequency, and nocturia, with or without incontinence. ConclusionsĪlthough OAB is common and morbid, in a longitudinal study using an EHR OAB phenotype 40% of patients were treated with OAB medication and only briefly. Patients who received OAB medications had significantly higher anticholinergic burden than patients who did not (anticholinergic total standardized daily dose, 125 versus 46 P < .001). Very few patients received other treatments: biofeedback (< 1%), onabotulinumtoxinA (2%), or sacral nerve stimulation (1%). Independent predictors of receipt of an OAB medication included increasing age (odds ratio, 1.4 for every 10 years 95% CI, 1.4 to 1.5), women (OR, 1.6 compared with men 95% CI, 1.4 to 1.8), diabetes (OR, 1.3 95% CI, 1.1 to 1.5), and certain sources of care compared with PCP-only care: PCP/specialty co-management (OR, 1.8 95% CI, 1.5 to 2.0), urology (OR, 2.2 95% CI, 1.8 to 2.6), and multiple specialists (OR, 1.4 95% CI, 1.2 to 1.8). The mean duration of prescribed medication was 1.5 months (95% confidence interval, 1.4 to 1.6 months range, < 1 month to 24 months). Only 40% of patients were prescribed at least 1 OAB medication during the study. The distribution of care included primary care physician (PCP)/specialty co-management (25% of patients) PCP care only (18%) urology only (13%) or some other combination of specialty care (33%). There were 7362 patients with an EHR OAB phenotype 50% of patients were > 65 years old, 74% were female, and 83% were white. We examined care from primary care and specialty clinics, medication and procedure use, and anticholinergic burden for each patient. We conducted a retrospective cohort study in a large, integrated health delivery system between July 2011 and June 2012 (2-year follow-up).

We used an “electronic health record (EHR) phenotype” to identify cases and describe treatment choices and anticholinergic burden for OAB. Medication and diagnosis claims may be specific, but lack sensitivity to identify patients with overactive bladder. Overactive bladder (OAB) is common and morbid.

Overactive bladder medication