Rethinking Second-Line Therapy for Overactive Bladder to Improve Patient Access to Treatment Options. [Review]

MedStar author(s):
Citation: Obstetrics & Gynecology. 137(3):454-460, 2021 03 01.PMID: 33543891Institution: MedStar Washington Hospital CenterDepartment: Obstetrics and Gynecology/Female Pelvic Medicine and Reconstructive SurgeryForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *Adrenergic beta-3 Receptor Agonists/tu [Therapeutic Use] | *Cholinergic Antagonists/ae [Adverse Effects] | *Dementia/ci [Chemically Induced] | *Health Services Accessibility/ec [Economics] | *Urinary Bladder, Overactive/dt [Drug Therapy] | Adrenergic beta-3 Receptor Agonists/ec [Economics] | Algorithms | HumansYear: 2021Local holdings: Available online from MWHC library: 1995 - present, Available in print through MWHC library: 1999 - 2006ISSN:
  • 0029-7844
Name of journal: Obstetrics and gynecologyAbstract: Idiopathic overactive bladder (OAB) is a chronic condition that negatively affects quality of life, and oral medications are an important component of the OAB treatment algorithm. Recent literature has shown that anticholinergics, the most commonly prescribed oral medication for the treatment of OAB, are associated with cognitive side effects including dementia. beta3-adrenoceptor agonists, the only alternative oral treatment for OAB, are similar in efficacy to anticholinergics with a more favorable side effect profile without the same cognitive effects. However, there are marked cost variations and barriers to access for OAB medications, resulting in expensive copays and medication trial requirements that ultimately limit access to beta3-adrenoceptor agonists and more advanced procedural therapies. This contributes to and perpetuates health care inequality by burdening the patients with the least resources with a greater risk of dementia. When prescribing these medications, health care professionals are caught in a delicate balancing act between cost and patient safety. Through multilevel collaboration, we can help disrupt health care inequalities and provide better care for patients with OAB. Copyright (c) 2021 by the American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved.All authors: Barnes HC, Bennett AT, Brown OE, Cardenas-Trowers OO, Chang OH, Escobar CM, Falk KN, Hall EF, Jeney SES, Mehta S, Menhaji K, Ringel NE, Sappenfield EC, Tellechea LMOriginally published: Obstetrics & Gynecology. 2021 Feb 04Fiscal year: FY2021Digital Object Identifier: Date added to catalog: 2021-02-18
Holdings
Item type Current library Collection Call number Status Date due Barcode
Journal Article MedStar Authors Catalog Article 33543891 Available 33543891

Available online from MWHC library: 1995 - present, Available in print through MWHC library: 1999 - 2006

Idiopathic overactive bladder (OAB) is a chronic condition that negatively affects quality of life, and oral medications are an important component of the OAB treatment algorithm. Recent literature has shown that anticholinergics, the most commonly prescribed oral medication for the treatment of OAB, are associated with cognitive side effects including dementia. beta3-adrenoceptor agonists, the only alternative oral treatment for OAB, are similar in efficacy to anticholinergics with a more favorable side effect profile without the same cognitive effects. However, there are marked cost variations and barriers to access for OAB medications, resulting in expensive copays and medication trial requirements that ultimately limit access to beta3-adrenoceptor agonists and more advanced procedural therapies. This contributes to and perpetuates health care inequality by burdening the patients with the least resources with a greater risk of dementia. When prescribing these medications, health care professionals are caught in a delicate balancing act between cost and patient safety. Through multilevel collaboration, we can help disrupt health care inequalities and provide better care for patients with OAB. Copyright (c) 2021 by the American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved.

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