TY  - BOOK
AU  - Ringel, Nancy E
TI  - Rethinking Second-Line Therapy for Overactive Bladder to Improve Patient Access to Treatment Options. [Review]
SN  - 0029-7844
PY  - 2021///
KW  - *Adrenergic beta-3 Receptor Agonists/tu [Therapeutic Use]
KW  - *Cholinergic Antagonists/ae [Adverse Effects]
KW  - *Dementia/ci [Chemically Induced]
KW  - *Health Services Accessibility/ec [Economics]
KW  - *Urinary Bladder, Overactive/dt [Drug Therapy]
KW  - Adrenergic beta-3 Receptor Agonists/ec [Economics]
KW  - Algorithms
KW  - Humans
KW  - MedStar Washington Hospital Center
KW  - Obstetrics and Gynecology/Female Pelvic Medicine and Reconstructive Surgery
KW  - Journal Article
N1  - Available online from MWHC library: 1995 - present, Available in print through MWHC library: 1999 - 2006
N2  - 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
UR  - https://dx.doi.org/10.1097/AOG.0000000000004279
ER  -