Title:Comprehensive Assessment of Compliance with Antimuscarinic Drug Treatment in the Case of Urge Urinary Incontinence of Older Patients
Volume: 10
Issue: 2
Author(s): Kirill V. Kosilov, Sergey A. Loparev, Irina G. Kuzina, Olga V. Shakirova, Natalya S. Zhuravskaya and Alexandra Lobodenko
Affiliation:
Keywords:
Adherence, antimuscarinic, older, urinary incontinence, treatment, urination diaries, urodynamics, uroflowmetry.
Abstract: Aim: To investigate the heterogeneous factors affecting the stability of patients older
than 60 years in the UI treatment with Antimuscarinics.
Background: The prevalence of Urge Incontinence (UI) in older persons reaches 29.3%. The
symptoms of urinary incontinence in older people reduce the health related life quality.
Materials and Methods: In 1257 patients over 60 years (857 (68.2%) women - average age 67.8,
400 (31.8%) men - 71.4), who received AM for one year, demographic, socio-economic and health
parameters were studied. OABq-SF questionnaires, MOS SF-36, urination diaries, uroflowmetry,
income information from the tax offices and outpatient records were used.
Result: The compliance to AM treatment within 6 months was retained in 44.2%, and within the
year - 26.8% of older patients. At least 40% of the total number of patients refused to continue the
treatment for medical reasons. The persons taking Solifenacin (p≤ 0.01), Trospium (p≤ 0.05), or
Darifenacin (p≤ 0.05), suffering from severe UI symptoms (p≤ 0.01), and experiencing minor side
effects (p≤ 0.01), well-informed about UI treatment methods (p≤ 0.01) prevailed among the treatment
compliant patients. At least 20.4% of the patients discontinued their treatment due to economic
reasons. The persons with significantly larger annual income (p≤ 0.05) and annual medical
cost (p≤ 0.01) prevailed among the treatment compliant patients. About 12.2% of the patients
stopped their treatment for reasons related to the social background and psychological status.
Conclusion: In this experiment, we found that AM treatment compliance in older patients, in addition
to medical parameters and health conditions, is largely affected by the economic as well as social,
demographic and psychological factors. The study results can be claimed by practitioners involved
in correcting UI symptoms in older people.
