title: Use of health care resources and associated costs in non-institutionalized vulnerable elders with overactive bladder treated with antimuscarinic agents in the usual medical practice.
abstract: OBJECTIVE
  To evaluate the use of resources and health costs in vulnerable elderly institutionalized patients with overactive bladder (OAB) treated with fesoterodine, tolterodine or solifenacin in routine medical practice.
  
  
  METHODS
  A multicenter retrospective study, from the records of patients treated during 2008-2010 in three geographical locations and starting treatment with antimuscarinic (fesoterodine, solifenacin and tolterodine) for OAB. The attribute of vulnerability was based on collecting at least 3 of the Vulnerable Elders Survey criteria-13, age>75 years, poor/average age for health and difficulty in at least one daily physical activity.
  
  
  METHODS
  morbidity, persistence and resource use and costs. Monitoring of patients was conducted over 52 weeks. A general linear model with covariates and bootstraping (1000) at random was used to construct the 95% CI of the cost differences between drugs.
  
  
  RESULTS
  Records of 552 patients (50.8% women, mean age: 80.2 years) were analyzed. Treated with fesoterodine (N=58), solifenacin (N=252) or tolterodine (N=212). The use of absorbent was 20.7%, 29.4% and 33.0% (P=.186), respectively. Persistence to treatment was slightly greater with fesoterodine. The patient healthcare costs/year were lower with fesoterodine, €1,775 (1550-2014) vs. solifenacin €2,062 (1911-2223) and tolterodine €2,149 (1,978-2,307), P=.042, as a result of lower utilization visits and concomitant medication.
  
  
  CONCLUSIONS
  Despite the potential limitations of the study, the vulnerable elderly non institutionalized patients with OAB treated with fesoterodine, compared to solifenacin or tolterodine were associated with lower resource utilization and healthcare costs.
authors.affiliation: Dirección de Planificación, Badalona Serveis Assistencials SA, Badalona, Barcelona, España. Electronic address: asicras@bsa.cat.
authors.forename: A
authors.initials: A
authors.lastname: Sicras-Mainar
authors.affiliation: Health Economics and Outcomes Research, Pfizer SLU, Alcobendas, Madrid, España.
authors.forename: J
authors.initials: J
authors.lastname: Rejas-Gutiérrez
authors.affiliation: Documentación Médica, Hospital Germans Trias i Pujol, Badalona, Barcelona, España.
authors.forename: R
authors.initials: R
authors.lastname: Navarro-Artieda
authors.affiliation: CAP Sagrada Familia, Consorci Sanitari Integral, Barcelona, España.
authors.forename: A
authors.initials: A
authors.lastname: Aguado-Jodar
authors.affiliation: Dirección de Atención Primaria, Servicio Balear de Salud, Ib-Salut, Mallorca, España.
authors.forename: A
authors.initials: A
authors.lastname: Ruíz-Torrejón
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001559:Benzhydryl Compounds / Q000191:economics* / Q000627:therapeutic use*; D005260:Female; D017048:Health Care Costs; D006295:Health Resources / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D018727:Muscarinic Antagonists / Q000191:economics* / Q000627:therapeutic use*; D012189:Retrospective Studies; D000069464:Solifenacin Succinate / Q000191:economics* / Q000627:therapeutic use*; D000068737:Tolterodine Tartrate / Q000191:economics* / Q000627:therapeutic use*; D053201:Urinary Bladder, Overactive / Q000188:drug therapy* / Q000191:economics*; D035862:Vulnerable Populations
chemical_list: D001559:Benzhydryl Compounds; D018727:Muscarinic Antagonists; D000068737:Tolterodine Tartrate; C526675:fesoterodine; D000069464:Solifenacin Succinate
keywords: Ancianos vulnerables; Antimuscarinic; Antimuscarínicos; Costes; Costs; Overactive bladder; Resource use; Uso de recursos; Vejiga hiperactiva; Vulnerable elderly