title: Discontinuation of treatment using anticholinergic medications in patients with urinary incontinence.
abstract: OBJECTIVE
  To evaluate the discontinuation rates of anticholinergics prescribed in patients with urinary incontinence (UI).
  
  
  METHODS
  Data from a Disease Analyzer database including 988 general, 95 urologist, and 203 gynecologic practices were examined. Twenty six thousand eight hundred thirty-four patients were identified as having received a first-time anticholinergic prescription for UI, namely darifenacin, fesoterodine, oxybutynin, propiverine, solifenacin, tolterodine, or trospium, between 2005 and 2012. Covariates studied included demographic data, concomitant diagnoses, and potential drug-induced side effects. The cumulative discontinuation rate of initial treatment was estimated using a Kaplan-Meier analysis. A Cox proportional hazard regression model was used to estimate the relationship between discontinuation and the demographic and clinical variables for up to 36 months.
  
  
  RESULTS
  An increasing discontinuation rate was observed in years 1, 2, and 3 (74.8%, 77.6%, 87%). Within 3 years, discontinuation rates were higher for men than for women (87.9%, 86.5%; P=.056; hazard ratio [HR] 1.14, 95% confidence interval [CI] 1.11-1.18; P<.001), for patients treated in gynecologic practices and general practices than those treated in urologist practices (HR 1.60; 95% CI 1.52-1.67, P<.001 and HR 1.24, 95% CI 1.20-1.29, P<.001, respectively) and for younger patients than those older than 80 year old (60 years or younger, HR 1.27, 95% CI 1.22-1.33; 61-70 years, HR 1.16, 95% CI 1.11-1.21; 71-80 years, HR 1.14, 95% CI 1.09-1.18, P<.001). Those using propiverine or solifenacin were less likely to discontinue treatment than those using oxybutynin (HR 0.94, 95% CI 0.88-0.99, P=.024 and HR 0.93, 95% CI 0.87-0.98, P=.004, respectively).
  
  
  CONCLUSIONS
  Patients with UI demonstrate high discontinuation rates for anticholinergics with only slight variations between the various drugs in this category.
  
  
  METHODS
  : III.
authors.affiliation: Department of Obstetrics and Gynecology, Philipps University of Marburg, Marburg, FOM University of Applied Sciences, Essen, and IMS Health, Frankfurt, Germany; and the 1st Department of Obstetrics and Gynecology and the 2nd Department of Obstetrics and Gynecology, Medical School, Aristotle University, Thessaloniki, Greece.
authors.forename: Matthias
authors.initials: M
authors.lastname: Kalder
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Pantazis
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Dinas
authors.forename: Ute-Susann
authors.initials: US
authors.lastname: Albert
authors.forename: Christina
authors.initials: C
authors.lastname: Heilmaier
authors.forename: Karel
authors.initials: K
authors.lastname: Kostev
mesh_terms: D000368:Aged; D018680:Cholinergic Antagonists / Q000009:adverse effects / Q000627:therapeutic use*; D015331:Cohort Studies; D016208:Databases, Factual; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D053201:Urinary Bladder, Overactive / Q000150:complications / Q000188:drug therapy*; D014549:Urinary Incontinence / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology; D014563:Urodynamics; D028761:Withholding Treatment
chemical_list: D018680:Cholinergic Antagonists