Quality‐of‐life aspects of the overactive bladder and the effect of treatment with tolterodine
Quality‐of‐life aspects of the overactive bladder and the effect of treatment with tolterodine
复制标题
膀胱过度活动症的生活质量以及托特罗定治疗的效果
作者：
Kobelt;Kirchberger;Malone
更多地涉及与患者和临床医生相关的问题，因此可以用于确定是否已经实现期望的治疗效果。膀胱过度活动症（OAB）是一种多症状问题，影响男女和所有年龄段的人，已经专门开发了针对尿失禁的仪器，包括Increase Impact，尽管它在老年人中更普遍[1-5]。OAB定义为尿急和尿频，有或没有问卷（IIQ）和尿窘迫量表（UDI）[16]，约克失禁感知量表急迫性尿失禁。尿失禁和尿急/尿频已被证明会影响患者的身体（YIPS）[17]、尿失禁生活质量（IQOL）[18]、尿失禁生活质量指数（IQOLI）[19]、社会和情感健康[6-12];任何治疗的有效性通常以国王健康问卷（KHQ）[20]的下降来衡量。这两种仪器是互补的，频率失禁。虽然这些临床有效性指标（通常是替代终点）通常很重要，但在QoL研究中将其合并。本综述的目的是讨论OAB的影响价值，尤其是在临床试验中，它们未能解决患者对OAB的QoL的疾病负担的概念，并从患者的角度分析有效和耐受性良好的药物可以实现的改善以及治疗的后果。测量这些患者衍生值是如托特罗定。我们使用SF 36和EuroQol来评估OAB对患者健康的影响，因此很重要，因为患者支付了更大部分的治疗费用，健康结果越来越多，而IQoLI和KHQ则用于研究托特罗定治疗的效果。从患者的角度对IQoLI进行了使用评价测试。在临床试验环境中，特定治疗和医疗保健提供系统的益处以及KHQ（迄今为止仅在女性患者中验证）也在一般情况下得到验证，将根据患者功能或健康的变化满足其在男性中使用的程度进行判断。需求和期望。主观生活质量（QoL）可以客观地衡量疾病的影响，并已开发，验证和广泛使用的几个工具。通用仪器SF 36是一种通用仪器，用于交叉研究，如MOS简表（SF）36 [13]提供了部分调查和临床试验。患者QoL的工具配置文件涵盖了几个健康问题，包括36个问题，有多个答案，这些问题是概念，通常分为身体，心理和分组为8个分量表测量8个健康社会领域。EuroQol EQ-5D概念或领域等工具。每个分量表单独评分[14，15]，将QoL作为指标进行测量，并提供0（最差）和100（最佳）之间的健康评分。它被集成在国家分类系统中，允许它们在瑞典公用事业分析的两个大型“支付意愿”（WTP）调查中使用。通用措施的优势是[21]，在美国[22]，急迫性和/或失禁患者的通用措施更全面，可以比较混合性失禁。在不同人群和疾病中，得分与自我评分相关。然而，它们被报告为频率和失禁的症状，并且通常不够敏感以检测患者愿意支付的治疗引起的金额的微小变化。具体措施是有针对性的症状缓解，以估计综合征对患者生活质量的影响。它也被用于临床研究，比较托特罗定与奥昔布宁和安慰剂，1998年12月3日发表
more to issues relevant to the patient and the clinician, Introduction and can thus be used to determine whether a desired treatment eCect has been achieved or not. Several The overactive bladder (OAB) is a multisymptomatic problem that aCects people of both sexes and all ages, instruments have been developed specifically for urinary incontinence, including the Incontinence Impact although it is more prevalent in the elderly [1–5]. The OAB is defined as urgency and frequency with or without Questionnaire (IIQ) and the Urinary Distress Inventory (UDI) [16], the York Incontinence Perception Scale urge incontinence. Urinary incontinence and urgency/ frequency have been shown to aCect a patient’s physical, (YIPS) [17], the Incontinence Quality of Life (IQoL) [18], the Incontinence Quality of Life Index (IQoLI) [19] social and emotional well-being [6–12]; the eBcacy of any treatment is generally measured as a decrease in and the King’s Health Questionnaire (KHQ) [20]. The two types of instruments are complementary and the frequency of incontinence. While such clinical eBcacy measures (often surrogate endpoints) are of great generally, they are combined in QoL research. The objective of this review is to discuss the impact value and particularly important in clinical trials, they fail to address the patients’ concept of disease burden on QoL of the OAB and analyse the improvements that can be achieved with an eCective and well-tolerated drug and the consequences of treatment from the patients’ perspective. Measuring these patient-derived values is such as tolterodine. We used the SF36 and the EuroQol to assess the impact of the OAB on patients’ well-being, therefore important, as patients are paying a larger part of treatment costs and health outcomes are increasingly and the IQoLI and the KHQ to investigate the eCect of treatment with tolterodine. The IQoLI was tested for use evaluated from the patients’ view. The benefits of specific treatments and of the healthcare delivery system in in a clinical trial setting and the KHQ, so far only validated with female patients, was also validated for general will be judged in terms of the extent to which changes in patients’ functioning or well-being meet their use in men. needs and expectations. Subjective quality of life (QoL) can be objectively Disease impact measured and several instruments have been developed, validated and used extensively. Generic instruments The SF36, a generic instrument, was used both in crosssuch as the MOS Short Form (SF) 36 [13] provide a sectional surveys and in clinical trials. The instrument profile of the patients’ QoL covering several health includes 36 questions with multiple answers that are concepts, generally grouped in physical, mental and grouped into eight subscales measuring eight health social domains. Instruments such as the EuroQol EQ-5D concepts or domains. Each subscale is scored individually [14,15] measure QoL as an index and provide a healthbetween 0 (worst) and 100 (best). It was integrated in state classification system that allows their use in costtwo large ‘willingness-to-pay’ (WTP) surveys in Sweden utility analyses. The advantage of generic measures is [21] and in the USA [22] of patients with urge and/or that they are more comprehensive and allow comparimixed incontinence. Scores were correlated with selfson across populations and diseases. However, they are reported symptoms of frequency and incontinence, and generally not sensitive enough to detect small changes to the amounts that patients were willing to pay for caused by treatment. Specific measures are targeted symptom relief, to estimate the impact of the syndrome on patients’ QoL. It was also used in a clinical study comparing tolterodine with oxybutynin and placebo over Accepted for publication 3 December 1998
DOI：
10.1016/s0022-5347(17)45194-9
发表时间：
1986-11
期刊：
The Journal of urology
影响因子：
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作者：
A. Diokno;A. Diokno;B. M. Brock;B. M. Brock;Morton B. Brown;Morton B. Brown;A. Herzog;A. Herzog
通讯作者：
A. Diokno;A. Diokno;B. M. Brock;B. M. Brock;Morton B. Brown;Morton B. Brown;A. Herzog;A. Herzog