Discontinuation Rates of Anticholinergic Medications Used for the Treatment of Lower Urinary Tract Symptoms
Discontinuation Rates of Anticholinergic Medications Used for the Treatment of Lower Urinary Tract Symptoms
复制标题
DOI：
10.1097/aog.0b013e31818e8aa4
复制
发表时间：
2008-12-01
影响因子：
7.2
通讯作者：
Arya, Lily A.
中科院分区：
文献类型：
--
作者：
Gopal, Manish;Haynes, Kevin;Arya, Lily A.
目的：评估用于治疗女性下尿路症状的抗胆碱能药物的停药率。年龄在18岁及以上的服用抗胆碱能药物的女性也包括在内。评估了9种不同抗胆碱能药物的总体和特定药物的停用率。研究的协变量包括以前使用的药物类别的数量、进行转换的数量、先前药物发作的数量、开始使用的年份、年龄和吸烟史。卡普兰-迈耶方法被用来估计总的停用率。结果：在29,369名女性中，有49,419次抗胆碱能药物治疗可供分析。平均每例患者治疗次数为1.65+/-1.31，药物种类数为1.54+/-0.57。停用抗胆碱能药物的中位时间为4.76个月。6个月未调整的累积停药发生率为58.8%(95%可信区间为58.4-59.3)。女性改用其他药物的比例为15.8%(95%可信区间15.4-16.1)。6个月时，调整后的累积停药发生率分别为：奥昔布宁71%(95%可信区间68.4~73.5)、酒石酸托特罗定61%(59.4、64.3)、缓释奥布宁57%(95%可信区间55.1~59.4)、酒石酸托特罗定缓释片54%(95%可信区间52.3~57.7)。
OBJECTIVE: To estimate the discontinuation rates of anticholinergic medications used for the treatment of lower urinary tract symptoms in women.METHODS: A large administrative database was used for this study. Women aged 18 years and older who were prescribed anticholinergic medications were included. An overall and drug-specific discontinuation rate for nine different anticholinergic medications was estimated. Covariates examined included number of prior drug classes used, number of switches performed, number of prior drug episodes, year of initiation, age, and history of smoking. The Kaplan-Meier method was used to estimate an overall discontinuation rate. A Cox multivariable regression was performed for the drug-specific analysis.RESULTS: There were 49,419 episodes of anticholinergic therapy available for analysis from 29,369 women. The average number of treatment episodes and number of drug classes prescribed per patient were 1.65 +/- 1.31 and 1.54 +/- 0.57, respectively. The median time for overall anticholinergic drug discontinuation was 4.76 months. The 6-month unadjusted cumulative incidence of discontinuation was 58.8% (95% confidence interval [CI] 58.4-59.3). The percentage of episodes in which women switched to another medication was 15.8% (95% CI 15.4-16.1). At 6 months, the adjusted cumulative incidence of discontinuation was as follows: oxybutynin 71% (95% CI 68.4-73.5), tolterodine tartrate 61% (59.4,64.3), extended-release oxybutynin 57% (95% CI 55.1-59.4), and extended-release tolterodine tartrate 54% (95% CI 52.3-57.7).CONCLUSION: Discontinuation rates for anticholinergic medications are high regardless of the class of medication used.