title: Symptom bother and health care-seeking behavior among individuals with overactive bladder.
abstract: OBJECTIVE
  To estimate symptom bother and health care seeking among individuals with overactive bladder (OAB; ie, cases) using current International Continence Society definitions.
  
  
  METHODS
  This was a nested case-controlled analysis of data from the EPIC study, a population-based, cross-sectional survey of adults in five countries. Cases and matched controls were asked about risk factors, use of coping techniques, and health care seeking for urinary symptoms. Cases were asked about symptom bother and assessed with the Overactive Bladder-Validated 8 and Patient Perception of Bladder Condition instruments.
  
  
  RESULTS
  Among cases (n=1434), 54% reported symptom bother; rates were similar between men (54%) and women (53%). Significantly more men with urinary incontinence (UI) reported bother (77%) than women with UI (67%; p<or=0.05). Among cases with UI who reported bother, more women (73%) than men (51%) used a urinary symptom coping technique, and the proportions were significantly greater than controls (men: 10%; women: 15%; p<or=0.05 for cases with UI vs. controls). Among cases using coping techniques, 63% of men and 69% of women initiated a conversation with a health care provider. Initiation of conversation with a health care provider was highest among cases who had a doctor visit within 6 mo (odds ratio [OR], 2.8), used coping techniques (OR, 2.2), or reported symptom bother (OR, 2.2).
  
  
  CONCLUSIONS
  Cases reporting symptom bother, particularly those with UI, were significantly more likely to use coping techniques and seek health care advice. Clinicians should screen for OAB in all cases and assess symptom bother in those affected to guide diagnosis and treatment.
authors.affiliation: Department of Epidemiology, University of North Carolina, Chapel Hill, NC, USA. dirwin@email.unc.edu
authors.forename: Debra E
authors.initials: DE
authors.lastname: Irwin
authors.forename: Ian
authors.initials: I
authors.lastname: Milsom
authors.forename: Zoe
authors.initials: Z
authors.lastname: Kopp
authors.forename: Paul
authors.initials: P
authors.lastname: Abrams
mesh_terms: D002170:Canada / Q000453:epidemiology; D016001:Confidence Intervals; D003430:Cross-Sectional Studies; D005060:Europe / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D010342:Patient Acceptance of Health Care / Q000523:psychology*; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D053201:Urinary Bladder, Overactive / Q000503:physiopathology / Q000523:psychology*; D014563:Urodynamics / Q000502:physiology*