title: Long-term efficacy and safety of questionnaire-based initiation of urgency urinary incontinence treatment.
abstract: OBJECTIVE
  The objective of the study was to determine the longer-term efficacy and safety of initiating treatment for urgency-predominant urinary incontinence (UUI) in women diagnosed using a simple questionnaire rather than an extensive evaluation.
  
  
  METHODS
  Women completing a 12 week randomized controlled trial of fesoterodine therapy for UUI diagnosed by questionnaire were invited to participate in a 9 month, open-label continuation study. UUI and voiding episodes were collected using voiding diaries. Participant satisfaction was measured by questionnaire. Safety was assessed by the measurement of postvoid residual volume and adverse event monitoring; if necessary, women underwent a specialist evaluation. The longitudinal changes in UUI and voiding episodes were evaluated using linear mixed models adjusting for baseline.
  
  
  RESULTS
  Of the 567 women completing the randomized trial, 498 (87.8%) took at least 1 dose of medication during this open-label study. Compared with the baseline visit in the randomized trial, fesoterodine was associated with a reduction in total incontinence episodes per day and urgency incontinence episodes per day at the end of the open-label study (adjusted mean [SE], 4.6 [0.12] to 1.2 [0.13] and 3.9 [0.11] to 0.9 [0.11], respectively, P < .0001 for both). Most women were satisfied with treatment (89%, 92%, and 93% at 3, 6, and 9 months, respectively). Twenty-six women experienced 28 serious adverse events, 1 of which was considered possibly treatment related. Twenty-two women had a specialist evaluation: 5 women's incontinence was misclassified by the 3 Incontinence Questions; none experienced harm because of misclassification.
  
  
  CONCLUSIONS
  Using a simple validated questionnaire to diagnose and initiate treatment for UUI in community-dwelling women is safe and effective, allowing timely treatment by primary care practitioners.
authors: Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA. hessr@upmc.edu
authors: Rachel
authors: R
authors: Hess
authors: Alison J
authors: AJ
authors: Huang
authors: Holly E
authors: HE
authors: Richter
authors: Chiara C
authors: CC
authors: Ghetti
authors: Vivian W
authors: VW
authors: Sung
authors: Elizabeth
authors: E
authors: Barrett-Connor
authors: W Thomas
authors: WT
authors: Gregory
authors: JoAnn V
authors: JV
authors: Pinkerton
authors: Catherine S
authors: CS
authors: Bradley
authors: Stephen R
authors: SR
authors: Kraus
authors: Rebecca G
authors: RG
authors: Rogers
authors: Leslee L
authors: LL
authors: Subak
authors: Karen C
authors: KC
authors: Johnson
authors: Lily A
authors: LA
authors: Arya
authors: Michael
authors: M
authors: Schembri
authors: Jeanette S
authors: JS
authors: Brown
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001559:Benzhydryl Compounds / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008875:Middle Aged; D018727:Muscarinic Antagonists / Q000627:therapeutic use*; D017060:Patient Satisfaction; D011795:Surveys and Questionnaires; D014549:Urinary Incontinence / Q000188:drug therapy*
chemical_list: D001559:Benzhydryl Compounds; D018727:Muscarinic Antagonists; C526675:fesoterodine
keywords: primary care; treatment; urgency urinary incontinence
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