Relationships among symptoms, bother, and treatment satisfaction in overactive bladder patients.
OBJECTIVE
We have studied the association between various symptoms, bother, and patient treatment satisfaction in overactive bladder (OAB).


METHODS
Episodes of urgency, incontinence, daytime frequency and nocturia and responses to the patient perception of bladder condition scale, the urgency perception scale, and visual analog scales of limitations in daily life and of treatment satisfaction were evaluated in 3,824 OAB patients at baseline and during 9 months treatment with tolterodine ER (4 mg q.d.) in an open-label, observational study. Relationships amongst number of symptoms/ 24 hr and scales were explored. Treatment satisfaction was correlated with improvements in symptoms and scales.


RESULTS
At baseline, the number of episodes of the four OAB symptoms correlated only poorly with each other and with the two bother-related scales, while the two scales assessing bother correlated much stronger with each other. Factor analysis identified four components which described "bother," "incontinence," "urgency/frequency," and "nocturia" and in combination explained 81.9% of the total variance. The component "bother" had the strongest individual effect accounting for 42.1% of the total variance. While improvements of symptoms and bother were seen with tolterodine treatment, patient treatment satisfaction correlated strongest with improvements of the two bother-related scales.


CONCLUSIONS
We conclude that the counting of episodes of OAB symptoms only insufficiently describes the afflicted patients. Patient bother is the strongest individual component but only poorly explained by episodes of the four symptoms defining OAB. Alterations of bother may better reflect patient-relevant outcomes in OAB treatment than alterations in the number of symptom episodes.
Michel
Martin C
MC
Department of Pharmacology & Pharmacotherapy, Academic Medical Center, University of Amsterdam, Meibergdreef 15, 1105 AZ Amsterdam, Netherlands. m.c.michel@amc.uva.nl
Oelke
Matthias
M
Goepel
Mark
M
Beck
Elmar
E
Burkart
Martin
M
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001559:Benzhydryl Compounds / Q000008:administration & dosage / Q000627:therapeutic use; D016000:Cluster Analysis; D003408:Cresols / Q000008:administration & dosage / Q000627:therapeutic use; D003692:Delayed-Action Preparations; D005163:Factor Analysis, Statistical; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018727:Muscarinic Antagonists / Q000008:administration & dosage / Q000627:therapeutic use; D053158:Nocturia / Q000188:drug therapy / Q000453:epidemiology; D017060:Patient Satisfaction; D010665:Phenylpropanolamine / Q000008:administration & dosage / Q000627:therapeutic use; D025341:Principal Component Analysis; D018709:Statistics, Nonparametric; D000068737:Tolterodine Tartrate; D016896:Treatment Outcome; D053201:Urinary Bladder, Overactive / Q000188:drug therapy* / Q000503:physiopathology* / Q000523:psychology; D014549:Urinary Incontinence / Q000188:drug therapy / Q000453:epidemiology
D001559:Benzhydryl Compounds; D003408:Cresols; D003692:Delayed-Action Preparations; D018727:Muscarinic Antagonists; D010665:Phenylpropanolamine; D000068737:Tolterodine Tartrate