title: Assessing the impact of nocturia on health-related quality-of-life and utility: results of an observational survey in adults.
abstract: OBJECTIVE
  The impact of nocturia (getting up at night to void) on health-related quality-of-life (HRQoL) is often under-estimated. This study investigated the relative burden in terms of HRQoL and utilities of nocturia in a real-world setting.
  
  
  METHODS
  Patient data were collected from two surveys: a nocturia-specific, cross-sectional survey of physicians and their patients (DSP), and a general UK population health survey (HSFE). Utilities (EQ-5D-5L), productivity (Work Productivity and Activity Index), and the impact of nocturia symptoms (Nocturia Impact Diary and Overactive Bladder Questionnaires) were assessed against the number of voids. A robust linear regression model with propensity score weights was used to control for confounding factors in estimating utilities.
  
  
  RESULTS
  Physician-recorded data were available from 8,738 patients across the US, Germany, Spain, France, and the UK; of these, 5,335 (61%) included patient-reported outcomes. In total, 6,302 controls were drawn from the two surveys and compared to 1,104 nocturia patients. Deterioration of HRQoL was associated with increasing number of night-time voids (p < 0.0001). In particular, significant differences were observed between 0-1 and ≥2 voids (p < 0.001). The regression model demonstrated that nocturia (≥2 per night) is associated with a modest but significant deterioration in utility of 0.0134 (p < 0.05).
  
  
  CONCLUSIONS
  The cause of nocturia is multifactorial and the mostly elderly patients may have several concomitant diseases. The authors tried to adjust for the most common ones, but there may be diseases or unknown relationships not included.
  
  
  CONCLUSIONS
  Nocturia negatively affected HRQoL and patient utility. A clear effect is seen already at two voids per night. Every effort should, therefore, be made to reduce nocturia below the bother threshold of two voids per night.
authors.affiliation: a Ferring Pharmaceuticals A/S , Copenhagen , Denmark.|b Center for Medical Technology Assessment (CMT), Linköping University , Linköping , Sweden.
authors.forename: Fredrik
authors.initials: F
authors.lastname: Andersson
authors.affiliation: c Adelphi Real World , Bollington , Cheshire , UK.
authors.forename: Peter
authors.initials: P
authors.lastname: Anderson
authors.affiliation: d Pharma Evidence , Farum , Denmark.
authors.forename: Tove
authors.initials: T
authors.lastname: Holm-Larsen
authors.affiliation: c Adelphi Real World , Bollington , Cheshire , UK.
authors.forename: James
authors.initials: J
authors.lastname: Piercy
authors.affiliation: e Department of Urology , Ghent University Hospital , Ghent , Belgium.
authors.forename: Karel
authors.initials: K
authors.lastname: Everaert
authors.affiliation: c Adelphi Real World , Bollington , Cheshire , UK.
authors.forename: Tim
authors.initials: T
authors.lastname: Holbrook
mesh_terms: D000368:Aged; D003430:Cross-Sectional Studies; D005060:Europe; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D053158:Nocturia / Q000523:psychology*; D011788:Quality of Life; D011795:Surveys and Questionnaires; D014481:United States
keywords: EQ-5D; Nocturia; Nocturia Impact (NI) diary; Observational survey; Quality-of-life (QoL); Utility; WPAI