title: Impact of solifenacin on resource utilization, work productivity and health utility in overactive bladder patients switching from tolterodine ER.
abstract: OBJECTIVE
  Assess changes in resource utilization, work and activity impairment, and health utility among OAB patients continuing to have urgency symptoms with tolterodine ER 4 mg and willing to try solifenacin 5/10 mg.
  
  
  METHODS
  This was an open-label, non-comparative, flexible-dosing, multicenter, 12-week study assessing the efficacy and safety of solifenacin 5/10 mg/day. Patients receiving tolterodine ER 4 mg/day for >/=4 weeks but continuing to experience residual urgency symptoms (>/=3 urgency episodes/24 h) were enrolled into the study. After a 14-day washout, patients began treatment with solifenacin 5 mg/day with dosing adjustments allowed at Weeks 4 and 8.
  
  
  METHODS
  Outcomes were assessed using the Work Productivity and Activity Impairment Questionnaire - Specific Health Problem (WPAI-SHP), Health Utilities Index (HUI), and a resource utilization questionnaire administered at Pre-Washout and Week 12.
  
  
  RESULTS
  Patients (n=440) reported significantly fewer physician office visits (p<0.0001), UTIs (p<0.0001), and pads/diapers (p=0.0009) during the study period while receiving solifenacin 5/10 mg/day, compared with the Pre-Washout period when receiving tolterodine ER 4 mg/day. After 12 weeks of treatment with solifenacin 5/10 mg/day, patients reported a reduction in work time missed (p=0.0017), less impairment while working (p<0.0001), less overall work impairment (p<0.0001) and a reduction in activity impairment (p<0.0001) compared to Pre-Washout. There was no significant difference in health utility scores. Treatment-emergent adverse events were mostly anticholinergic in nature, and were mild to moderate in severity.
  
  
  CONCLUSIONS
  Overall, solifenacin 5/10 mg/day improved work productivity, activity participation, and reduced medical care use in OAB patients who continued to have urgency symptoms with tolterodine ER 4 mg/day and wished to switch to solifenacin 5/10 mg. This was an open-label, non-comparative study; therefore, further research is needed to confirm these results.
authors.affiliation: Western Clinical Research, Torrance, CA, USA. wewedoc@aol.com
authors.forename: Norman
authors.initials: N
authors.lastname: Zinner
authors.forename: Les
authors.initials: L
authors.lastname: Noe
authors.forename: Lawrence
authors.initials: L
authors.lastname: Rasouliyan
authors.forename: Thomas
authors.initials: T
authors.lastname: Marshall
authors.forename: Raafat
authors.initials: R
authors.lastname: Seifeldin
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D001559:Benzhydryl Compounds / Q000008:administration & dosage / Q000494:pharmacology* / Q000627:therapeutic use; D003408:Cresols / Q000008:administration & dosage / Q000494:pharmacology* / Q000627:therapeutic use; D003692:Delayed-Action Preparations; D005260:Female; D006296:Health Services / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D018727:Muscarinic Antagonists / Q000008:administration & dosage / Q000494:pharmacology* / Q000627:therapeutic use; D017063:Outcome Assessment, Health Care; D010342:Patient Acceptance of Health Care; D010665:Phenylpropanolamine / Q000008:administration & dosage / Q000494:pharmacology* / Q000627:therapeutic use; D011788:Quality of Life; D011812:Quinuclidines / Q000008:administration & dosage / Q000494:pharmacology* / Q000627:therapeutic use; D000069464:Solifenacin Succinate; D011795:Surveys and Questionnaires; D044005:Tetrahydroisoquinolines / Q000008:administration & dosage / Q000494:pharmacology* / Q000627:therapeutic use; D000068737:Tolterodine Tartrate; D053201:Urinary Bladder, Overactive / Q000188:drug therapy* / Q000503:physiopathology
chemical_list: D001559:Benzhydryl Compounds; D003408:Cresols; D003692:Delayed-Action Preparations; D018727:Muscarinic Antagonists; D011812:Quinuclidines; D044005:Tetrahydroisoquinolines; D010665:Phenylpropanolamine; D000068737:Tolterodine Tartrate; D000069464:Solifenacin Succinate