MP37-15 PERCUTANEOUS TIBIAL NEUROMODULATION INITIAL THERAPY COMPLIANCE AND SUBSEQUENT THIRD-LINE TREATMENT PATTERNS

Abstract

You have accessJournal of UrologyCME1 Apr 2023MP37-15 PERCUTANEOUS TIBIAL NEUROMODULATION INITIAL THERAPY COMPLIANCE AND SUBSEQUENT THIRD-LINE TREATMENT PATTERNS Priya Padmanabhan, Bernadette Zwaans, Ryan Boldt, and Charlotte Wu Priya PadmanabhanPriya Padmanabhan More articles by this author , Bernadette ZwaansBernadette Zwaans More articles by this author , Ryan BoldtRyan Boldt More articles by this author , and Charlotte WuCharlotte Wu More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003275.15AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Percutaneous Tibial Neuromodulation (PTNM) is a therapy for Overactive Bladder (OAB) delivered over 12 consecutive weekly sessions. However, little is known about the application and adherence of this treatment in a real-world setting. This analysis aims to summarize patients’ time to complete treatment course and examine trends of third-line therapy use--Sacral Neuromodulation (SNM) and Botox®--during and after the treatment course. METHODS: Optum’s Clinformatics® Data Mart (CDM) Database and CMS Research Identifiable File (RIF) healthcare claims were queried for adults diagnosed with urgency, frequency and urge incontinence and underwent PTNM treatment during 2019—allowing for a 1-year follow-up period. Patients were required to have continuous enrollment and pharmacy coverage. PTNM treatment within 30 days of a previous treatment was defined as part of the initial therapy. Compliance was defined as 12 PTNM-related visits. Primary outcomes were percentage of compliant PTNM-related visits within 1 year and total number of patients with SNM and Botox® within the same year, segmented by 12-, 15-, 22-, and 52-week periods. RESULTS: 3,087 patients were included from CDM and 9,727 patients from RIF data. Completion of initial treatment (12 treatments) increased over time; 16% at week 12 to 42% by week 52 and 24% to 38% for CDM and RIF data, respectively (Figure 1; both p<0.001). Similarly, utilization of third-line therapy increased over time and was higher for non-compliant patients: 0.2% of compliant and 0.8% of non-compliant CDM patients used Botox within 12 weeks. However, 4.9% of compliant and 6.4% of non-compliant CDM patients used Botox within 52 weeks; p=0.035. Similarly, SNM implant within 12 weeks was <1% for CDM patients, and within 52 weeks were 1.2% of compliant and 2.6% of non-compliant patients; p=0.002. Patients in the RIF data followed similar trends. CONCLUSIONS: Most patients are not compliant with the recommended treatment regimen of 12 PTNM treatments in 12 weeks. Non-compliant patients were more likely to pursue third-line treatment options. Signaling the effectiveness of PTNM therapy for patients with OAB symptoms may be severely underestimated. This is valuable in consideration of implantable tibial technology. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e520 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Priya Padmanabhan More articles by this author Bernadette Zwaans More articles by this author Ryan Boldt More articles by this author Charlotte Wu More articles by this author Expand All Advertisement PDF downloadLoading ...