TY - JOUR
T1 - Rethinking Second-Line Therapy for Overactive Bladder to Improve Patient Access to Treatment Options
AU - Escobar, Christina M.
AU - Falk, Kerac N.
AU - Mehta, Shailja
AU - Hall, Evelyn F.
AU - Menhaji, Kimia
AU - Sappenfield, Elisabeth C.
AU - Brown, Oluwateniola E.
AU - Ringel, Nancy E.
AU - Chang, Olivia H.
AU - Tellechea, Laura M.
AU - Barnes, Hayley C.
AU - Jeney, Sarah E.S.
AU - Bennett, Alaina T.
AU - Cardenas-Trowers, Olivia O.
N1 - Funding Information:
Financial Disclosure : Dr. Escobar receives research funding from Watkins-Conti unrelated to this work. Dr. Cardenas-Trowers received research funding from AMAG Pharmaceuticals, Inc. unrelated to this work. Dr. Mehta receives research funding from PFD Research Foundation unrelated to this work. The other authors did not report any potential conflicts of interest.
Publisher Copyright:
© 2021 Lippincott Williams and Wilkins. All rights reserved.
PY - 2021/3/1
Y1 - 2021/3/1
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. β3-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 β3-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.
AB - 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. β3-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 β3-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.
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U2 - 10.1097/AOG.0000000000004279
DO - 10.1097/AOG.0000000000004279
M3 - Review article
C2 - 33543891
AN - SCOPUS:85102211410
SN - 0029-7844
VL - 137
SP - 454
EP - 460
JO - Obstetrics and gynecology
JF - Obstetrics and gynecology
IS - 3
ER -
