Listening to the patient: a flexible approach to the use of antimuscarinic agents in overactive bladder syndrome.
Several studies with modern antimuscarinics have used a flexible-dosing strategy. We reviewed data from several studies with solifenacin, darifenacin and oxybutynin extended-release that evaluated the impact of dose flexibility on clinical management. A strategy based on patient-requested dose increases was found to be consistently effective in improving the symptoms of overactive bladder. Patients requesting a dose increase often had more severe symptoms at baseline than those who did not request a dose increase, and these patients derived most benefit from the increased dose. Specialists and family doctors should encourage open discussion with their patients about requesting dose titration so as to meet patients' individual needs.
Chapple
Christopher R
CR
Department of Urology, Royal Hallamshire Hospital, Sheffield, UK. c.r.chapple@sheffield.ac.uk
Rosenberg
Matt T
MT
Brenes
Francisco J
FJ
D001572:Benzofurans / Q000008:administration & dosage; D004334:Drug Administration Schedule; D006801:Humans; D008333:Mandelic Acids / Q000008:administration & dosage; D015337:Multicenter Studies as Topic; D018727:Muscarinic Antagonists / Q000008:administration & dosage*; D017060:Patient Satisfaction; D011759:Pyrrolidines / Q000008:administration & dosage; D011812:Quinuclidines / Q000008:administration & dosage; D016032:Randomized Controlled Trials as Topic; D000069464:Solifenacin Succinate; D044005:Tetrahydroisoquinolines / Q000008:administration & dosage; D053201:Urinary Bladder, Overactive / Q000188:drug therapy* / Q000523:psychology
D001572:Benzofurans; D008333:Mandelic Acids; D018727:Muscarinic Antagonists; D011759:Pyrrolidines; D011812:Quinuclidines; D044005:Tetrahydroisoquinolines; C101207:darifenacin; C005419:oxybutynin; D000069464:Solifenacin Succinate