Evidence map›Paper›PMID 39029804›Full record

ArticleUrology2024

Frailty, Specialized Care, and Sociodemographic Factors: Disparities in Oral Pharmacotherapy Class Utilization Among Medicare Part D Beneficiaries With Overactive Bladder in the United States.

Ekene A Enemchukwu, Shada Sinclair, Hodan Mohamud, Chiyuan A Zhang, Jennifer T Anger, Charles D Scales

Abstract read
In one paragraph

Article in Urology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
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

4 citing papers in PubMed.

  1. Article
  2. Review
  3. Health Disparities and Overactive Bladder: Bridging the Gap.Current bladder dysfunction reports · 2026
    Review
  4. 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.

Ekene A EnemchukwuStanford School of Medicine, Palo Alto, CA. Electronic address: enemche@stanford.edu.
Shada SinclairStanford School of Medicine, Palo Alto, CA.
Hodan MohamudUniversity of Toronto, Toronto, Ontario, Canada.
Chiyuan A ZhangStanford School of Medicine, Palo Alto, CA.
Jennifer T AngerUniversity of California San Diego, La Jolla, CA.
Charles D ScalesDuke University School of Medicine, Durham, NC.

Funding

UrogynCREST ProgramR25HD094667 · NICHD · DUKE UNIVERSITY · PI Cindy Amundsen · 2019 to 2026
$1.2M
Improving Overactive Bladder Treatment Access and Adherence Through Personalized Behavioral Modifications and Mobile Technology-Based InterventionsK23DK131315 · NIDDK · STANFORD UNIVERSITY · PI Ekene Enemchukwu · 2022 to 2026
$971k
NICHD NIH HHS R25 HD094667NIDDK NIH HHS K23 DK131315
6 · The paper itself

Abstract

objectiveTo describe the prevalence of frailty among Medicare beneficiaries with overactive bladder (OAB), analyze oral therapy patterns, and examine potential disparities in treatment.

methodsThis retrospective cohort study utilized the 20% Research Identifiable File Medicare Part D prescription claims dataset (2013-2018). Using the Claims-Based Frailty Index (CFI), Medicare beneficiaries ≥65 years old with OAB were categorized as not frail (CFI <0.15), prefrail (0.15 ≤CFI<0.25), and frail (CFI >0.25). Logistic regression models assessed associations between frailty and pharmacotherapy utilization.

resultsAmong 111,761 patients (15.8% of the OAB cohort) receiving oral pharmacotherapy (anticholinergic oral medications or mirabegron), 71% were women, 83% were White, and 11.9% were frail. After controlling for age, copayments and dual eligibility status, frail status (OR 1.16; 95% CI [1.09-1.24]), urology (OR 2.05; 95% CI [1.94-2.16]) or gynecology (OR 1.74; 95% CI [1.6-1.9]) prescribers and residing in the Southern United States (OR 1.53; CI [1.49-1.61]) were associated with higher likelihood of mirabegron utilization. Black (OR 0.79; 95% CI [0.74-0.85]) and American Indian/Alaska Native (OR 0.54; 95% CI [0.39-0.74]) patients were less likely to utilize Mirabegron than White beneficiaries.

conclusionFrail beneficiaries and those with urology and gynecology prescribers showed higher likelihoods of beta-3 agonist utilization. Despite adjustments, Black and American Indian/Alaskan Native patients were less likely to fill mirabegron prescriptions, suggesting disparities in treatment. Our findings highlight the need for policies, interventions, and initiatives to promote equitable OAB oral therapy utilization in vulnerable populations.

Indexed as

AcetanilidesHealthcare DisparitiesMedicare Part DUrinary Bladder, OveractiveAdministration, OralAgedAged, 80 and overCholinergic AntagonistsCohort StudiesFemaleFrailtyHumansMaleRetrospective StudiesSociodemographic FactorsThiazolesAcetanilidesCholinergic AntagonistsmirabegronThiazoles

Identifiers

PMID39029804
PMCPMC11486448

What OpenQuestion holds

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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.