title: Impact of Loss of Work Productivity in Patients with Overactive Bladder Treated with Antimuscarinics in Spain: Study in Routine Clinical Practice Conditions.
abstract: BACKGROUND
  Overactive bladder (OAB) is a syndrome characterized by presenting symptoms of urgency, with or without urge incontinence, and normally accompanied by day and night frequency.
  
  
  OBJECTIVE
  The aim of this study was to evaluate the impact of lost work productivity [number of days of sick leave] in patients treated with fesoterodine versus tolterodine and solifenacin to treat OAB in Spain.
  
  
  METHODS
  A retrospective, observational study was carried out using the records (digital databases) of actively working patients (2008-2013). The study population comprised of patients from two autonomous communities; 31 primary care centres agreed to participate. Patients who began first treatment with antimuscarinics (fesoterodine, solifenacin or tolterodine) and who met certain inclusion/exclusion criteria were included in the study. Follow-up lasted for 1 year. The main outcome measures were comorbidity, medication possession ratio (MPR), treatment persistence, and number of days of sick leave and associated costs. Indirect costs were considered to be those related to lost work productivity (number of days of sick leave, exclusively), (1) due to OAB and (2) overall total. The cost was expressed as the average cost per patient (cost/unit). Multivariate analyses (Cox, ANCOVA) were used to correct the models.
  
  
  RESULTS
  A total of 3094 patients were recruited into the study; 43.0 % were treated with solifenacin, 29.2 % with tolterodine, and 27.8 % with fesoterodine. The average age of patients was 54 years (standard deviation 9.2), and 62.2 % were women. The comparison of fesoterodine versus solifenacin and tolterodine showed a higher MPR (90.0 vs. 87.0 and 86.1 %, respectively), higher treatment persistence (40.2 vs. 34.7 and 33.6 %), lower use of sick leave (22.8 vs. 52.9 and 36.7 %), total number of days of sick leave (5.1 vs. 9.7 and 9.3 days) and costs corrected for covariates (€371 vs. €703 and €683); p < 0.05.
  
  
  CONCLUSIONS
  Despite the possible limitations of this study, active patients who began treatment with fesoterodine to treat OAB (compared with solifenacin or tolterodine) had fewer days of sick leave, resulting in lower costs due to lost productivity.
authors.affiliation: Badalona Serveis Assistencials, Calle Gaietà Soler, 6-8 entlo, 08911, Badalona, Barcelona, Spain. asicras@bsa.cat.
authors.forename: Antoni
authors.initials: A
authors.lastname: Sicras-Mainar
authors.affiliation: Medical Documentation, Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain.
authors.forename: Ruth
authors.initials: R
authors.lastname: Navarro-Artieda
authors.affiliation: ib-Salut, Majorca, Spain.
authors.forename: Amador
authors.initials: A
authors.lastname: Ruiz-Torrejón
authors.affiliation: GRECS, Universitat de Girona, Girona, Spain.
authors.forename: Marc
authors.initials: M
authors.lastname: Sáez-Zafra
authors.affiliation: Research Unit, IAS, Girona, Spain.
authors.forename: Gabriel
authors.initials: G
authors.lastname: Coll-de Tuero
mesh_terms: D000328:Adult; D001559:Benzhydryl Compounds / Q000191:economics / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D018727:Muscarinic Antagonists / Q000191:economics / Q000627:therapeutic use*; D011320:Primary Health Care / Q000191:economics / Q000639:trends; D012189:Retrospective Studies; D018582:Sick Leave / Q000191:economics / Q000639:trends*; D000069464:Solifenacin Succinate / Q000191:economics / Q000627:therapeutic use; D013030:Spain / Q000453:epidemiology; D000068737:Tolterodine Tartrate / Q000191:economics / Q000627:therapeutic use; D016896:Treatment Outcome; D053201:Urinary Bladder, Overactive / Q000188:drug therapy* / Q000191:economics / Q000453:epidemiology*; D053202:Urinary Incontinence, Urge / Q000188:drug therapy / Q000191:economics / Q000453:epidemiology; D000066477:Work Performance / Q000191:economics / Q000639:trends*
chemical_list: D001559:Benzhydryl Compounds; D018727:Muscarinic Antagonists; D000068737:Tolterodine Tartrate; C526675:fesoterodine; D000069464:Solifenacin Succinate