Portal de Periódicos da CAPES

Predictors of Medication Adherence and Associated Health Care Costs in an Older Population With Overactive Bladder Syndrome: A Longitudinal Cohort Study

2006; Lippincott Williams & Wilkins; Volume: 175; Issue: 3 Linguagem: Inglês

10.1016/s0022-5347(05)00352-6

1527-3792

Rajesh Balkrishnan, Monali Bhosle, Fabian Camacho, Roger T. Anderson,

Gastroesophageal reflux and treatments

No AccessJournal of UrologyAdult urology1 Mar 2006Predictors of Medication Adherence and Associated Health Care Costs in an Older Population With Overactive Bladder Syndrome: A Longitudinal Cohort Studyis corrected byErrata Rajesh Balkrishnan, Monali J. Bhosle, Fabian T. Camacho, and Roger T. Anderson Rajesh BalkrishnanRajesh Balkrishnan Department of Pharmacy Practice and Administration, Ohio State University, Columbus, Ohio , Monali J. BhosleMonali J. Bhosle Department of Pharmacy Practice and Administration, Ohio State University, Columbus, Ohio , Fabian T. CamachoFabian T. Camacho Department of Pharmacy Practice and Administration, Ohio State University, Columbus, Ohio Department of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, North Carolina , and Roger T. AndersonRoger T. Anderson Department of Pharmacy Practice and Administration, Ohio State University, Columbus, Ohio Department of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, North Carolina View All Author Informationhttps://doi.org/10.1016/S0022-5347(05)00352-6AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We examined the relationship between self-reported health status data, subsequent antimuscarinic medication adherence and health care service use in older adults with OAB syndrome in a managed care setting. Materials and Methods: This was a longitudinal cohort study of older adults in the southeastern United States with OAB who completed a health status assessment, used antimuscarinic medications and were enrolled in an HMO continuously for 1 to 3 years. Demographic, clinical and use related economic variables were also retrieved from the administrative claims data of patient HMOs. Prescription refill patterns were used to measure medication adherence. Associations were examined with a sequential, mixed model regression approach. Results: A total of 275 patients were included. The severity of comorbidity (Charlson index), patient perception of quality of life (Short Form-12 scores) and total number of prescribed medications during the year prior to enrollment in a Medicare HMO were independently associated with decreased antimuscarinic MPRs after enrollment. After controlling for other variables increased antimuscarinic MPR remained the strongest predictor of decreased total annual health care costs (5.6% decrease in annual costs with every 10% increase in MPR, p <0.001). Conclusions: We found strong associations between decreased antimuscarinic medication adherence and increased health care service use in older adults with OAB in a managed care setting. Health status assessments completed at enrollment had the potential to identify enrollees at higher risk for nonadherent behaviors and poor health related outcomes. References 1 : The standardisation of terminology of lower urinary tract function: report from the Standardisation Sub-committee of the International Continence Society. Am J Obstet Gynecol2002; 187: 116. Google Scholar 2 : Costs of urinary incontinence and overactive bladder in the United States: a comparative study. Urology2004; 63: 461. Google Scholar 3 : The prevalence of overactive bladder. Am J Manag Care2000; 6: S565. Google Scholar 4 : Management of detrusor dysfunction in the elderly: changes in acetylcholine and adenosine triphosphate release during aging. Urology2004; 63: 17. Google Scholar 5 : The patient with an overactive bladder—symptoms and quality-of-life issues. Urology1997; 50: 18. Google Scholar 6 : Health-related quality of life among adults with symptoms of overactive bladder: results from a U. S. community-based survey. Urology2001; 57: 1044. Google Scholar 7 : Coping strategies and health care-seeking behavior in a US national sample of adults with symptoms suggestive of overactive bladder. Clin Ther2001; 23: 1245. Google Scholar 8 : Overview of patient compliance with medication dosing: a literature review. Clin Ther1984; 6: 592. Google Scholar 9 : Predictors of medication adherence in the elderly. Clin Ther1998; 20: 764. Google Scholar 10 : The implications of poor medication persistence with treatment for overactive bladder. Manag Care Interface2004; 17: 54. Google Scholar 11 : Elevating our therapeutic expectations in overactive bladder. J Am Acad Nurse Pract2004; 16: 8. Google Scholar 12 : Validation of patient reports, automated pharmacy records, and pill counts with electronic monitoring of adherence to antihypertensive therapy. Med Care1999; 37: 846. Google Scholar 13 : A general method of compliance assessment using centralized pharmacy records. Description and validation. Med Care1988; 26: 814. Google Scholar 14 : new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis1987; 40: 373. Google Scholar 15 : Adapting a clinical comorbidity index for use with ICD-9-CM administrative databases. J Clin Epidemiol1992; 45: 613. Google Scholar 16 : The Interpretation of Dummy variables in Semilogarithmic Equations. Am Econ Rev1980; 70: 474. Google Scholar 17 : Estimation with correctly interpreted dummy variables in semilogarithmic equations. Am Econ Rev1981; 71: 801. Google Scholar 18 : Predictors of medication adherence and associated health care costs in an older population with type 2 diabetes mellitus: a longitudinal cohort study. Clin Ther2003; 25: 2958. Google Scholar 19 : Self-reported health status, prophylactic medication use, and healthcare costs in older adults with asthma. J Am Geriatr Soc2002; 50: 924. Google Scholar 20 : Drugs and the elderly, part 1: the problems facing managed care. Am J Manag Care2000; 6: 1313. Google Scholar © 2006 by American Urological AssociationFiguresReferencesRelatedDetailsCited ByMoskowitz D, Adelstein S, Lucioni A, Lee U and Kobashi K (2018) Use of Third Line Therapy for Overactive Bladder in a Practice with Multiple Subspecialty Providers—Are We Doing Enough?Journal of Urology, VOL. 199, NO. 3, (779-784), Online publication date: 1-Mar-2018.MacDiarmid S, Al-Shukri S, Barkin J, Fianu-Jonasson A, Grise P, Herschorn S, Saleem T, Huang M, Siddiqui E, Stölzel M, Hemsted C, Nazir J, Hakimi Z and Drake M (2018) Mirabegron as Add-On Treatment to Solifenacin in Patients with Incontinent Overactive Bladder and an Inadequate Response to Solifenacin MonotherapyJournal of Urology, VOL. 196, NO. 3, (809-818), Online publication date: 1-Sep-2016.Veenboer P and Bosch J (2018) Long-Term Adherence to Antimuscarinic Therapy in Everyday Practice: A Systematic ReviewJournal of Urology, VOL. 191, NO. 4, (1003-1008), Online publication date: 1-Apr-2014.Sears C, Lewis C, Noel K, Albright T and Fischer J (2018) Overactive Bladder Medication Adherence When Medication is Free to PatientsJournal of Urology, VOL. 183, NO. 3, (1077-1081), Online publication date: 1-Mar-2010.Ozkurkcugil C and Ozkan L (2018) Re: Overactive Bladder Medication Adherence When Medication is Free to PatientsJournal of Urology, VOL. 184, NO. 4, (1575-1575), Online publication date: 1-Oct-2010.Related articlesJournal of Urology9 Nov 2018Errata Volume 175Issue 3March 2006Page: 1067-1072 Advertisement Copyright & Permissions© 2006 by American Urological AssociationKeywordsagedmuscarinic antagonistsbladderurination disordersmanaged care programsMetricsAuthor Information Rajesh Balkrishnan Department of Pharmacy Practice and Administration, Ohio State University, Columbus, Ohio More articles by this author Monali J. Bhosle Department of Pharmacy Practice and Administration, Ohio State University, Columbus, Ohio More articles by this author Fabian T. Camacho Department of Pharmacy Practice and Administration, Ohio State University, Columbus, Ohio Department of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, North Carolina More articles by this author Roger T. Anderson Department of Pharmacy Practice and Administration, Ohio State University, Columbus, Ohio Department of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, North Carolina More articles by this author Expand All Advertisement PDF DownloadLoading ...