PUR2: EVIDENCE OF DISEASE PROGRESSION IN ADULT PATIENTS WITH AN OVERACTIVE BLADDER (OAB)

Abstract

OBJECTIVES. This study examined patterns of transition of bladder symptoms in adult patients with an overactive bladder, identified risk factors for such transitions, and assessed the impact of symptom transition on patient outcomes of depression and accidental falls. METHODS: This study was a retrospective, population based cohort study using the General Practice Research Database (GPRD) containing medical records from 550 of 686 general practices in the UK. The baseline period included the year in which a patient's first OAB symptom or diagnosis record occurred and the following year. The follow-up period was six years. A total of 9,706 patients, aged 40 years or older met the criteria. Transition rates from frequency/urgency to incontinence, and from urge incontinence to frequency/urgency were calculated. Logistic regression was used to examine the impact of risk factors on symptom transition, and its effect on a patient's risk of depression and accidental fall. RESULTS: Of female patients with OAB, 23.4% had “frequency/urgency” at baseline and developed “incontinence” in the follow-up period—potentially reflecting progression of the condition. Factors associated with progression of OAB included older patients (70 to 90 years), female gender, urgency, accidental falls, multiple sclerosis, and epilepsy. Controlling for these factors, patients with progression showed an increased risk of depression and accidental fall compared to patients who had no change in symptoms (adjusted odds ratios 1.44 and 1.35, respectively; p = 0.0001 for both). CONCLUSION: OAB appears to be a progressive disease. A significant proportion of patients progressed from “dry” to “wet” symptoms. This may imply that some patients with OAB, if left un-treated, will develop progression of OAB over time. The risks of depression and accidental falls were significantly increased in those patients whose OAB condition worsened. Further research is required to determine whether treatment can prevent, reduce, or delay the progression of OAB syndrome.