Background: Nocturia, characterized as waking during the main sleep period to urinate, is a common condition. Persistent nocturia results in sleep fragmentation with deleterious effects on health and well-being. Yet, there are limited data on the economic burden of nocturia in the United States.
Objective: To assess the association of nocturia with health care resource utilization (HRU), work productivity, and self-rated health while estimating the societal costs of nocturia in the United States in 2017.
Methods: A retrospective cross-sectional study was conducted using data from the National Health and Nutrition Examination Survey (NHANES; 2005-2006 to 2013-2014). Adults aged ≥ 18 years (excluding pregnant women) were stratified into individuals with nocturia (≥ 2 voids/night) and individuals without nocturia (< 2 voids/night), based on the threshold for clinically significant nocturia. Outcomes were self-reported and included HRU (hospitalizations, outpatient visits); work productivity (weekly hours worked, employment); and current health status. Multivariable regression analyses adjusting for age, race, sex, body mass index, insurance status, education level, alcohol use, smoking status, and self-reported comorbid conditions were used to compare the 2 cohorts, overall and stratified by age group (20-44 years, 45-64 years, and 65+ years) to distinguish the effects on different age groups including the Medicare-aged population. Excess direct health care costs and indirect productivity costs associated with nocturia in the United States were then calculated using a prevalence-based approach and available literature (i.e., nocturia prevalence estimates, aggregated unit costs by HRU type, and average hourly earnings in the United States).
Results: 22,300 individuals were identified, and 24% had nocturia (≥ 2 voids/night). Median age was 55.2 and 43.2 years among individuals with and without nocturia, respectively, and the proportion of males was 43.3% and 51.3%, respectively. Individuals with nocturia had significantly more HRU, including hospitalizations and outpatient visits, worked significantly fewer hours weekly, and were significantly less likely to be employed when compared with those without nocturia. They were also significantly less likely to report being in very good/excellent health. These comparisons remained statistically significant across age groups. Total excess direct health care costs were $62.9 billion (hospitalization: $47.6 billion; outpatient: $15.3 billion). Total excess indirect productivity costs were $151.7 billion. Altogether, costs were estimated at $214.5 billion, equivalent to $3,491 per individual with nocturia. Individuals aged 20-44 years incurred 23.5% of total excess costs, while those aged 45-64 and 65+ years incurred 48.2% and 28.3%, respectively. Sensitivity analyses based on lower prevalence estimates resulted in costs of $94.0 billion, while those based on higher prevalence estimates reached up to $231.1 billion.
Conclusions: Nocturia is associated with a substantial economic burden in the United States even when evaluated based on lower prevalence estimates. This study underscores the importance of timely diagnosis and management of nocturia patients to alleviate health-related and economic consequences to patients and society.
Disclosures: This work was supported by Ferring Pharmaceuticals, which contributed to and approved the study design and participated in the interpretation of data, review, and approval of the manuscript. Gauthier-Loiselle, Gagnon-Sanschagrin, and Wu are employees of Analysis Group, which received consultancy fees from Ferring Pharmaceuticals for work on this study. Jhaveri is a full-time employee of Ferring Pharmaceuticals. Parts of this work were presented as a poster presentation at AMCP Nexus 2018; October 22-25, 2018; Orlando, FL.
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http://dx.doi.org/10.18553/jmcp.2019.19191 | DOI Listing |
Urogynecology (Phila)
January 2025
From the Division of Urogynecology & Reconstructive Pelvic Surgery, Department of OB/GYN, Harbor-UCLA Medical Center, Torrance CA.
Importance: Obstructive sleep apnea (OSA) is common but likely underdiagnosed in urogynecology patients with nocturia, and OSA treatment has the potential to improve nocturia symptoms.
Objective: The aim of the study was to assess the effect of implementing a universal screening protocol for OSA in a urogynecology clinic on screening rates, OSA prevalence among patients with nocturia, and symptom improvement following treatment.
Study Design: This was an observational quality improvement study at a urogynecology clinic at a safety-net hospital.
Cureus
December 2024
Rehabilitation, Hanoi Medical University, Hanoi, VNM.
Managing overactive bladder (OAB) in children is recommended to involve rehabilitation intervention including urotherapy, clean intermittent catheterization (CIC), and medication. However, there is scarce evidence on the management of OAB in children in Vietnam, as well as the effectiveness of combining urotherapy, CIC, and medication in managing this condition. We report a case of an 11-year-old female pediatric patient with OAB following aneurysmal bone cyst (ABC) surgery.
View Article and Find Full Text PDFSci Rep
January 2025
The Affiliated Lihuili Hospital of Ningbo University, Ningbo, Zhejiang, People's Republic of China.
Nocturia is the most prevalent lower urinary tract symptom (LUTS) and is closely associated with various diseases and social burdens. Research on the relationship between physical activity and various diseases has progressed significantly. However, the association between nocturia and physical activity has received limited attention in prior studies.
View Article and Find Full Text PDFJ Med Imaging Radiat Oncol
January 2025
Sydney Fibroid Clinic, Sydney, New South Wales, Australia.
Background: Pelvic Congestion Syndrome (PCS) is a condition characterised by chronic pelvic pain resulting from the dilation and reflux of veins within the pelvis. While pelvic pain is the primary symptom of PCS, other associated symptoms may vary among individuals. Bladder symptoms have been commonly observed in PCS, including increased urination frequency, urinary urgency, nocturia and rarely haematuria.
View Article and Find Full Text PDFPurpose: To develop a predictive model for fall risk in pre-frail older adults, providing a basis for early identification and prevention of falls among this population.
Method: This was a multicenter prospective cohort study. A total of 473 pre-frail older adults were included, 335 as the training set and 142 as the test set.
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