Barriers and facilitators to overactive bladder therapy adherence. Issue 8 (5th May 2022)

• Record Type: Journal Article
• Authors: Enemchukwu, Ekene A.; Subak, Leslee L.; Markland, Alayne
• Is Part Of: Neurourology and urodynamics. Volume 41:Issue 8(2022)
• Page Start: 1983
• Page End: 1992
• Publication Date: 2022-05-05
• Subjects: behavioral therapy -- overactive bladder -- patient‐centered care -- pharmacotherapy -- therapy adherence -- third‐line therapy -- urinary incontinence; Urinary organs -- Periodicals; Urodynamics -- Periodicals; Urology -- Periodicals; 616.6
• DOI: 10.1002/nau.24936
• Languages: English
• ISSNs: 0733-2467

Abstract

Abstract: Aims: To provide an overview of the barriers and facilitators to overactive bladder (OAB) therapy initiation and adherence. Methods: A PubMed and Embase literature search was conducted to identify barriers to OAB therapy adherence. Results: OAB therapy adherence is associated with improvements in urinary symptoms, and quality of life with reductions in annual costs for OAB‐related expenditures. However, adherence rates to behavioral therapies are as low as 32% at 1 year, only 15%‐40% of treated patients remain on oral medications at 1 year due to several factors (e.g., inadequate efficacy, tolerability, and cost), and 5%−10% of OAB patients progress to advanced therapies. While some common barriers to therapy adherence are often fixed (e.g., costs, lack of efficacy, time, side effects, treatment fatigue), many are modifiable (e.g., lack of knowledge, poor relationships, negative experiences, poor communication with providers). Patient‐centered care may help address some modifiable barriers. Emerging data demonstrate that patient‐centered care in the form of treatment navigators improves OAB therapy adherence and progression to advanced therapies in the appropriate patient. Conclusions: There are numerous modifiable barriers to OAB therapy adherence. A patient‐centered lens is needed to elicit patient goals, establish realistic treatment expectations, and tailor therapy to improve therapy adherence, optimize outcomes, and reduce healthcare expenditures. Further research is needed to develop and study low‐cost, scalable solutions.