Evidence map›Paper›PMID 27924187›Full record

ArticleAmerican health & drug benefits2016

Evaluating Outcomes in Patients with Overactive Bladder within an Integrated Healthcare Delivery System Using a Treatment Patterns Analyzer.

Daniel B Ng, Melissa McCart, Christopher Klein, Chelsey Campbell, Robert Schoenhaus, Todd Berner

Open access · greenAbstract read
In one paragraph

Article in American health & drug benefits, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
1.8field-weighted citation impact, top 15% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it, 7 citations in OpenAlex.

  1. Pooled it
  2. CUA guideline on adult overactive bladder.Canadian Urological Association journal = Journal de l'Association des urologues du Canada · 2017
    Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 4 institutions in 3 countries.

Daniel B NgAssociate Director, Health Economics and Clinical Outcomes Research, Astellas Pharma Global Development, Northbrook, IL.
Melissa McCartAssistant Director, Global Health Economics and Outcomes Research, Xcenda, Palm Harbor, FL.
Christopher KleinSenior Software Engineer, Technology and Innovation, Xcenda.
Chelsey CampbellAssistant Director, Global Health Economics and Outcomes Research, Xcenda.
Robert SchoenhausPharmacoeconomics Unlimited, San Diego, CA.
Todd BernerDirector, Health Economics and Clinical Outcomes Research, Astellas Scientific and Medical Affairs, Northbrook, IL.
Health Economics and Outcomes Research (United Kingdom) · GBAscendis Pharma (Denmark) · DKAstellas Pharma (United States) · USDucks Unlimited · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundOveractive bladder (OAB) is a relatively common disease that has been linked to a variety of comorbidities, reductions in quality of life, and increased healthcare costs. Antimuscarinic agents are the standard of care among pharmacologic treatments for OAB, but these drugs are linked to high levels of anticholinergic burden, especially in the elderly.

objectiveTo demonstrate how efficient data analysis can be used to identify gaps in care as a result of improvement strategies for OAB within an integrated healthcare delivery system setting.

methodsWe developed an OAB treatment patterns analyzer, a clinical outcomes software analysis program, to identify gaps in care, high anticholinergic burden, and potential quality improvement initiatives. Deidentified pharmacy and medical claims data from an integrated delivery network were imported into the OAB treatment patterns analyzer. Patients with a diagnosis of OAB who were continuously enrolled in the network between January 1, 2009, and December 31, 2013, were identified and were imported into the analyzer. The analyzer used National Drug Code;

resultsOf 157,710 members in the integrated delivery network population, 7309 patients met the study eligibility criteria. Of patients taking medications for OAB, 85% were nonadherent and 73% discontinued treatment within 1 year. Among 1147 patients in the integrated healthcare delivery system who were using medications for OAB, 39 (3.4%) patients were concomitantly taking anticholinesterase drugs and an antimuscarinic agent. The per-month plan-paid cost per member was $318.67. Of all the patients with OAB within the population, the rates of all-cause office visits, emergency department visits, and hospitalizations were 81%, 6%, and 4%, respectively. The rate of clinically relevant anticholinergic burden was 16%, with higher rates among patients with dementia who were also receiving a branded (20%) or generic (24%) antimuscarinic drug.

conclusionIn patients using medications for the treatment of OAB, the rates of medication persistence and adherence were poor. Antimuscarinic medications may place certain patient populations at risk for increased anticholinergic burden. Data included in the analyzer can be used to implement member-specific strategies to prevent poor outcomes and reduce associated healthcare costs and utilization.

Indexed as

adherenceanticholinergic drugsantimuscarinic drugsdrug utilization managementgenitourinary systemhealthcare utilizationoveractive bladderpersistencepharmacy practicequality improvement

Identifiers

PMID27924187
PMCPMC5123653
OpenAlexW2521502493

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.