title: Immediate-release oxybutynin versus tolterodine in detrusor overactivity: a population analysis.
abstract: We evaluated adherence to treatment with immediate-release (IR) oxybutynin (515 patients) and tolterodine (505 patients) for detrusor overactivity through retrospective analysis of a pharmacy claims database. Outcomes included percentage of patients continuing therapy for 6 months, medication possession ratios, and time to discontinuation of therapy. The proportion of patients continuing therapy for 6 months was statistically superior for tolterodine (32%) compared with IR oxybutynin (22%, p<0.001). Medication possession ratios were also superior for patients in the tolterodine group (medians 0.83 and 0.64, ranges 0.11-1.15 and 0.07-1.13, respectively, p<0.001). Oxybutynin was discontinued significantly earlier (mean 45 days) than tolterodine (mean 59 days, p<0.001) and was switched to another therapy more commonly than tolterodine (19% and 14%, respectively). Tolterodine was favored over oxybutynin for several measurements of patient adherence. However, less than one-third of patients continued therapy with either agent for 6 months. The clinical relevance of these differences is unknown.
authors.affiliation: Express Scripts Inc., Bloomington, Minnesota 55439-0842, USA.
authors.forename: M
authors.initials: M
authors.lastname: Lawrence
authors.forename: D R
authors.initials: DR
authors.lastname: Guay
authors.forename: S R
authors.initials: SR
authors.lastname: Benson
authors.forename: M J
authors.initials: MJ
authors.lastname: Anderson
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001559:Benzhydryl Compounds / Q000627:therapeutic use*; D015331:Cohort Studies; D003408:Cresols / Q000627:therapeutic use*; D011307:Drug Prescriptions / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D008333:Mandelic Acids / Q000627:therapeutic use*; D008875:Middle Aged; D018727:Muscarinic Antagonists / Q000627:therapeutic use*; D010276:Parasympatholytics / Q000627:therapeutic use*; D010593:Pharmaceutical Services / Q000706:statistics & numerical data; D010665:Phenylpropanolamine; D012189:Retrospective Studies; D013997:Time Factors; D000068737:Tolterodine Tartrate; D014549:Urinary Incontinence / Q000188:drug therapy*
chemical_list: D001559:Benzhydryl Compounds; D003408:Cresols; D008333:Mandelic Acids; D018727:Muscarinic Antagonists; D010276:Parasympatholytics; D010665:Phenylpropanolamine; D000068737:Tolterodine Tartrate; C005419:oxybutynin