Survey assessment of continuation of and satisfaction with pharmacological treatment for urinary incontinence.
OBJECTIVE
To evaluate treatment satisfaction and compliance with pharmacologic therapy in urinary incontinence patients.


METHODS
An online survey was returned by 1447 individuals from a nationwide panel of adults who had previously reported treatment for incontinence symptoms and agreed to participate in survey research. Data on demographics, incontinence severity, treatment compliance, and satisfaction were obtained. Logistic regression was used to estimate crude and adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for characteristics associated with pharmacologic treatment dissatisfaction and discontinuation.


RESULTS
The sample was predominantly female (87%) and white (93%) with a mean age of 56 years. On average, patients urinated 10 times/day and experienced 16 wetting accidents in the week preceding survey. Overall, 25% reported being somewhat or very dissatisfied with treatment. Those who reported a severe effect of incontinence on their lives were most likely to be dissatisfied (OR = 2.82, 95% CI = 1.89-4.23). Discontinuation of drug treatment was reported by 45% of study subjects, with major reasons being poor efficacy (in 41.3% of discontinuations), side effects (22.4%), and cost (18.7%). Predictors for discontinuation included young age (OR = 1.8, 95% CI = 1.2-2.8), experiencing symptoms for 10 or more years (OR = 1.5, 95% CI = 1.1-2.0), and experiencing more than 16 wetting accidents in the last week (OR = 1.6, 95% CI = 1.3-2.1).


CONCLUSIONS
This online survey of self-selected incontinence patients indicated that almost half of those who have received drug treatment for incontinence had discontinued primarily because of lack of efficacy, side effects, and cost concerns. Our findings suggest a substantial degree of unmet need from current therapy among those with incontinence.
Campbell
Ulka B
UB
Cerner Galt, New York, NY 10003 USA. ulka.campbell@gmail.com
Stang
Paul
P
Barron
Rich
R
D000293:Adolescent; D000328:Adult; D000368:Aged; D001559:Benzhydryl Compounds / Q000627:therapeutic use; D003408:Cresols / Q000627:therapeutic use; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008333:Mandelic Acids / Q000627:therapeutic use; D008875:Middle Aged; D018727:Muscarinic Antagonists / Q000627:therapeutic use; D010349:Patient Compliance; D017060:Patient Satisfaction; D010665:Phenylpropanolamine / Q000627:therapeutic use; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D000068737:Tolterodine Tartrate; D016896:Treatment Outcome; D014481:United States; D014549:Urinary Incontinence / Q000188:drug therapy*
D001559:Benzhydryl Compounds; D003408:Cresols; D008333:Mandelic Acids; D018727:Muscarinic Antagonists; D010665:Phenylpropanolamine; D000068737:Tolterodine Tartrate; C005419:oxybutynin