title: Effects of combined behavioral intervention and tolterodine on patient-reported outcomes.
abstract: OBJECTIVE
  To assess the effects of tolterodine extended release (ER) plus behavioral intervention on urgency and other patient-reported outcomes in subjects with overactive bladder (OAB) who were previously dissatisfied with antimuscarinic treatment.
  
  
  METHODS
  In this 16-week, multicenter, open-label study, eligible adults (aged > or = 18 y) reported dissatisfaction with their most recent antimuscarinic OAB medication; > or = 8 micturitions and > or = 2 urgency episodes per 24 hours and > or = 1 UUI episode in 5 day bladder diaries; and OAB symptoms for > or = 3 months. Subjects received tolterodine ER plus a behavioral educational handout with verbal reinforcement of behavioral intervention content for 8 weeks. Those satisfied with treatment at week 8 continued with this therapy; those dissatisfied received tolterodine ER plus individualized behavioral intervention (pelvic floor muscle training, tailored behavioral techniques) for 8 weeks. Endpoints were changes from baseline in daytime and nocturnal micturition-related urgency episodes and frequency-urgency sum (a measure of urgency severity and frequency) reported in 5 day bladder diaries at weeks 4, 8, 12, and 16; Patient Perception of Bladder Condition (PPBC), Overactive Bladder Questionnaire (OAB-q), and Urgency Perception Scale (UPS) scores at weeks 8 and 16.
  
  
  RESULTS
  Daytime and nocturnal urgency episodes and frequency-urgency sum were significantly reduced at all time points (all p < 0.0001). Significant improvements were also observed in PPBC, OAB-q Symptom Bother and Health-Related Quality of Life, and UPS scores at weeks 8 and 16 (all p < 0.0001).
  
  
  CONCLUSIONS
  Patients with OAB who are dissatisfied with antimuscarinic therapy may experience improved treatment outcomes by adding a self-administered behavioral intervention to their drug regimen.
authors.affiliation: School of Nursing, University of Minnesota, Minneapolis, Minnesota 55455, USA.
authors.forename: Jean F
authors.initials: JF
authors.lastname: Wyman
authors.forename: Carl
authors.initials: C
authors.lastname: Klutke
authors.forename: Kathryn
authors.initials: K
authors.lastname: Burgio
authors.forename: Zhonghong
authors.initials: Z
authors.lastname: Guan
authors.forename: Franklin
authors.initials: F
authors.lastname: Sun
authors.forename: Sandra
authors.initials: S
authors.lastname: Berriman
authors.forename: Tamara
authors.initials: T
authors.lastname: Bavendam
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001521:Behavior Therapy; D001559:Benzhydryl Compounds / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D003408:Cresols / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018727:Muscarinic Antagonists / Q000627:therapeutic use*; D017060:Patient Satisfaction; D010665:Phenylpropanolamine / Q000627:therapeutic use*; D000068737:Tolterodine Tartrate; D016896:Treatment Outcome; D053201:Urinary Bladder, Overactive / Q000628:therapy*; D055815:Young Adult
chemical_list: D001559:Benzhydryl Compounds; D003408:Cresols; D018727:Muscarinic Antagonists; D010665:Phenylpropanolamine; D000068737:Tolterodine Tartrate