Long-term adherence to antimuscarinic drugs when treating overactive bladder in the older: Subjective reason and objective factors

PURPOSE: Comparison of subjective reasons for the refusal of antimuscarinic treatment and the state of objective economic, social, psychological and health status markers in the elderly with overactive bladder. MATERIALS AND METHODS: One thousand seven hundred thirty-six (1,736) patients participated in the experiment: 1,036 or 59.7% of women, and 700 or 40.3% of men aged over 60 years (average age, 68.1 years) who took antimuscarinic (AM) drugs during the year. The control of objective parameters was carried out by studying patients' medical records, the use of overactive bladder questionnaire short form and Medical Outcomes Study 36-item Shor-Form Health Survey, voiding diaries, uroflowmetry, as well as income certificates from the Tax Inspectorate, support documentation for expenses on drugs. RESULTS: Fifty-two point six percent (52.6%) of patients preserved adherence to treatment during the first 6 months, 30.1% – during the follow-up period. The average time of reaching a 30-day break in the AM drugs administration was 174 days. In 36.5% of cases of the refusal of treatment, patients referred to medical reasons for the refusal, in 31.6% of cases disturbance was established in objective health status markers (differences were significant in 30% of the follow-up time). The percentage of refusals of treatment for social and psychological reasons (13.2%) was significantly lower (p≤0.05), than the percentage of individuals with statuses altered objectively (21.9%). CONCLUSIONS: A significant share of elderly patients taking AM drugs when treating overactive bladder is inclined to overestimate the importance of health factors influencing their decisions and to underestimate the importance of social and psychological factors, and an urologist should take it into account for the efficacy evaluation.