Objective: The aim of this study was to evaluate the persistence of first line anticholinergic medication use by patients with overactive bladder (OAB). Data from a hospital outpatient database were matched with information obtained by a telephone survey of patients to determine which patients discontinued use of anticholinergic medication and to identify the reasons underlying discontinuation.
Material And Methods: The study group included 377 OAB patients (52 men, 325 women) with a mean age of 60.29 ± 13.84 years. In total, 189 patients (50.1%) were treated with trospium (median dose 27.86 ± 12.73 mg), 41 patients (10.9%) with propiverine (28.17 ± 4.97 mg), nine patients (2.4%) with extended-release tolterodine (4.0 ± 0 mg), 48 patients (12.7%) with solifenacin (5.94 ± 1.97 mg) and 90 patients (23.9%) with fesoterodine (6.09 ± 2.01 mg).
Results: The median time for persistence with the first line anticholinergic treatment was 6.53 ± 3.84 months. Persistence was significantly higher in patients treated with anticholinergic medication with an extended-release formulation than in patients treated with immediate-release anticholinergics. The most common reasons for termination of treatment were healing/resolution of symptoms (35.9%), low effectiveness (30.9%) and side-effects (23.7%).
Conclusions: More than half of the OAB patients were not satisfied with their first line treatment. Other treatment options should be sought, such as changing the medication or dosage, or possibly combining treatments.
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http://dx.doi.org/10.3109/21681805.2013.814707 | DOI Listing |
Sci Rep
December 2024
Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA, USA.
The unintended consequences of polypharmacy pose significant risks to older adults. The complexities of managing numerous medications from multiple prescribers demand a comprehensive approach to mitigate harms. Pharmacist-led clinics have been shown to improve outcomes in patients with diabetes and hypertension.
View Article and Find Full Text PDFTher Adv Drug Saf
December 2024
Faculty of Pharmacy, Université Laval, CEVQ, 1050 Chemin Ste-Foy, Quebec, QC G1S 4L8, Canada.
Background: As the number of medications increases, the appropriateness of polypharmacy may become questionable due to the heightened risk of medication-related harm.
Objectives: (1) To investigate the relationship between the number of current medications used by older adults and three indicators of potentially inappropriate polypharmacy: (a) the mean number of potentially inappropriate medications (PIMs), (b) the average count of drug-drug interactions, and (c) the anticholinergic burden; (2) To characterize the population-based burden of potentially inappropriate polypharmacy by calculating the proportion of individuals with these indicators.
Design: We conducted a population-based observational study using the Quebec Integrated Chronic Disease Surveillance System.
Front Mol Neurosci
December 2024
Laboratory of Neuropsychiatry, Psychiatric Centre Copenhagen, Mental Health Services in the Capital Region of Denmark and University of Copenhagen, Copenhagen, Denmark.
Objective: Acetylcholine modulates the activity of the direct and indirect pathways within the striatum through interaction with muscarinic M and M receptors. M receptors are uniquely positioned to regulate plasticity within the direct pathway and play a substantial role in reward and addiction-related behaviors. However, the role of M receptors on cholinergic neurons has been less explored.
View Article and Find Full Text PDFArch Razi Inst
June 2024
Medical Plants Research Center, Basic Health Sciences Institute, Shahrekord University of Medical Sciences, Shahrekord, Iran.
In the present study, the mechanisms involved in scopolamine-induced memory impairment have been investigated. The molecular events that take place during memory mostly include mechanisms that are seen in the acquisition phase. Results showed that one of the mechanisms of memory destruction caused by scopolamine, in addition to weakening the cholinergic system, is the indirect effect of scopolamine on other neurotransmitter systems, including the glutamatergic system.
View Article and Find Full Text PDFJ Am Med Dir Assoc
December 2024
Division of Geriatrics, University of Health Sciences, Gulhane Faculty of Medicine and Gulhane Training and Research Hospital, Ankara, Türkiye. Electronic address:
Objectives: Frailty has been shown to be linked with orthostatic hypotension (OH) in older adults, but the role of anticholinergic drugs in this relationship never has been explored. The purpose of this was to examine the relationship between anticholinergic burden (ACB) and OH in frail older adults living in the community and to examine whether this association differs according to polypharmacy.
Design: A cross-sectional study.
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