Publications by authors named "Covernton P"

Background: Patients with overactive bladder may cycle through different antimuscarinic medications even though there is limited evidence to support this approach.

Objective: To describe treatment patterns and the associated health care resource utilisation (HCRU) according to antimuscarinic cycling groups.

Design, Setting, And Participants: The CYCLe AntiMuscarinics in ENgland (CYCLAMEN) study was a retrospective observational investigation that used primary care records from the Clinical Practice Research Datalink GOLD database linked to Hospital Episode Statistics secondary care data.

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Objective: To characterize first therapeutic change and healthcare resource utilization in older men initiating an overactive bladder (OAB) or benign prostatic obstruction (BPO) medication.

Methods: A retrospective cohort study using health administrative data from ICES in Ontario, Canada (from April 01, 2010 to December 31, 2018) was conducted in men aged ≥66 years with ≥1 OAB (β3 agonist, antimuscarinic) or BPO (α-blocker, 5-α-reductase inhibitor) prescription and ≥1-year postindex data (index=first observed dispensation).

Exclusions: prescriptions for these drugs ≤1 year preindex, a related procedure ≤5 years.

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Introduction And Aim: Overactive bladder (OAB) negatively impacts patient quality of life and may be associated with high resource use. Our aim was to describe the resource use, costs and persistence associated with mirabegron (MB) or antimuscarinic (AM) treatment in patients with OAB.

Materials And Methods: Observational retrospective study of medical records in adult patients initiating OAB treatment with MB or AM in Catalonia.

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Background: Combination drug therapy for lower urinary tract symptoms (LUTS) is beneficial to selected patients and recommended by guidelines. Patterns of real-world LUTS drug use, especially combination drug therapy, have not been studied extensively. Moreover, further understanding of the recent landscape is required following the introduction of the beta-3-adrenoceptor agonist mirabegron in the UK in 2013 for overactive bladder (OAB).

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Background: Bladder anticholinergics are the most widely used drugs to treat overactive bladder (OAB) but can contribute to cumulative anticholinergic burden, which may be associated with adverse outcomes.

Objective: This study aimed to evaluate the association between cumulative anticholinergic burden and healthcare resource utilization (HRU) and costs in older adults with OAB.

Materials And Methods: This was a retrospective, observational study that used data from the UK Clinical Practice Research Datalink (CPRD) GOLD database.

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Introduction: Combination therapy with an alpha blocker (AB) plus an antimuscarinic (AM) is recommended for men with moderate-to-severe mixed lower urinary tract symptoms (LUTS) when monotherapy is not effective in relieving storage symptoms. This study compared treatment persistence and adherence with an AB plus AM fixed-dose combination (FDC) vs an AB plus AM free-dose combination in men with LUTS in Spain.

Methods: Retrospective study using the Spanish IQVIA Cegedim Electronic Medical Records database.

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Aims: To evaluate the diagnostic ability of different cough stress tests (CSTs) in women with pelvic organ prolapse (POP), performed during outpatient urogynaecological exams.

Methods: Prospective, multicentre observational study involving women on waiting lists for POP surgery. With a subjectively full bladder, patients were asked to perform five different CSTs: without prolapse reduction ([a] standing, followed by [b] semilithotomy position); keeping semilithotomy position with prolapse reduced (by [c] posterior speculum, followed by [d] pessary); [e] standing again with the pessary in place.

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Introduction: Pharmacotherapy for overactive bladder (OAB) is generally associated with low rates of persistence and adherence. This study was conducted to explore the patient journey in a UK primary care setting (experiences, perceptions, attitudes, and levels of engagement and expectations) and identify self-reported reasons for patient non-adherence and/or non-persistence to medications for OAB.

Methods: This was a qualitative, non-interventional study involving one-to-one semi-structured, face-to-face or phone interviews with individuals aged 40-80 years, diagnosed with OAB, and currently taking, or having taken, either antimuscarinic or β-adrenoceptor agonist medications within the last 12 months.

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Alterations in nicotinic acetylcholine (nAChR) receptor number can be induced by chronic exposure to nicotine possibly by stabilization of the desensitized state(s) of the receptor. Since within the central nervous system (CNS), many nAChRs are localized presynaptically, we have investigated the physiological consequences of prolonged nicotine applications on spontaneous transmitter release. In the presence of glutamate receptor antagonists, bicuculline-sensitive spontaneous GABA inhibitory synaptic currents (IPSCs) could be readily resolved in whole-cell recordings from neurons in the interpeduncular nucleus (IPN) maintained as brain slices.

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Assessing the potential of nicotinic agonists as therapeutic agents has frequently relied upon single component EC(50) values obtained from studies of nicotinic receptors expressed in Xenopus oocytes. We have evaluated the validity of this approach using voltage clamp techniques. In general, agonist concentration-response plots for the alpha3beta2, alpha3beta4, alpha4-1beta2, alpha4-1beta4 and alpha7 combinations were poorly fitted by a single component Hill-equation.

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The properties of wild type and mutant rat nicotinic alpha7 receptors expressed in Xenopus oocytes were investigated using electrophysiology and site-directed mutagenesis. When compared at individual agonist concentrations, neither the normalised nicotinic, nor acetylcholine, responses of the wild type receptors were significantly different from the corresponding responses obtained from a first extracellular domain mutant, phenylalanine(189)tyrosine (P0.05).

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1. We have studied the effects of acute ethanol (EtOH) exposure on the agonist responses of rat neuronal nicotinic receptors expressed in Xenopus oocytes by means of voltage clamp techniques. 2.

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1. The agonist sensitivity of nicotinic acetylcholine receptors in rat superior cervical ganglion (SCG) neurones was compared with that of cloned receptors expressed in Xenopus oocytes by pairwise injections of alpha 3-beta 2 or alpha 3-beta 4 neuronal nicotinic subunit combinations. 2.

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