Health-related consequences of overactive bladder.

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Am J Manag Care. 2002 Dec;8(19 Suppl):S598-607. Related Articles,

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Health-related consequences of overactive bladder.

Wagner TH, Hu TW, Bentkover J, LeBlanc K, W, Corey R, Zhou

Z, Hunt T.

Health Economics Resource Center, Department of Veterans Affairs,

Stanford University School of Medicine, Menlo Park, California, USA.

OBJECTIVE: Overactive bladder (OAB) is a condition of urgency, with

or without urge incontinence, usually with frequency and nocturia. This

study assesses whether people with OAB are at greater risk for urinary

tract infections (UTIs), falls and injuries, and increased number of

visits to the doctor compared to age- and gender-matched controls. The

study also estimates costs associated with these health-related

consequences. PATIENTS & METHODS: A US representative telephone survey

under the National Overactive Bladder Evaluation (NOBLE) Program was

conducted with 5204 English-speaking adults older than 18 years. The

survey asked respondents about bladder symptoms. Based on the telephone

survey, 865 symptom-identified OAB cases and 903 age- and

gender-matched controls were sent a postal questionnaire. A total of

397 cases and 522 controls returned the questionnaires. Nonrespondent

cases and controls did not differ with regard to age, gender,

educational status, diabetes, congestive heart failure, and self-rated

health status. Regression analyses were conducted to assess the effect

of OAB on health-related consequences, controlling for age, gender,

race, education, marital status, number of previous births,

self-reported health status, diabetes, and congestive heart failure.

RESULTS: People with OAB reported 0.84 (20%) more visits to the

physician (P < .05) and 0.21 (138%) more UTIs in the last year than

people without OAB (P < .001). Overactive bladder cases also had over

twice the odds of being injured in a fall than people without OAB (odds

ratio = 2.26; 95% confidence interval 1.46, 3.51). Consistent with

having more falls, OAB cases had an increased risk of bone fracture (P

< .1). This effect, however, was not statistically significant (at

alpha level 0.05) due to the limited sample size. The estimated cost of

UTIs associated with OAB was approximately $1.37 billion US dollars in

year 2000. The cost of falls without bone fracture due to OAB was $55

million. Falls with bone fracture accounted for approximately $386

million; however, further research with a larger sample is needed to

accurately estimate these costs. CONCLUSION: People with OAB

self-report significantly more UTIs and a greater risk of being injured

in a fall. Given the large prevalence of UTIs and concerns of

overprescribing antibiotics, these results are important for health

plans and policy makers. In addition, people with OAB visit their

physicians more often than people without OAB. These consequences

entail significant economic costs, of which a large percentage will be

incurred by health plans. To the extent that OAB causes these

consequences, there may be significant savings from effectively

treating OAB.

PMID: 12516954 [PubMed - indexed for MEDLINE]

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?

cmd=Retrieve & db=PubMed & list_uids=12516954 & dopt=Abstract