TY - JOUR
T1 - Patient preferences for treating refractory overactive bladder in the UK
AU - Hashim, Hashim
AU - Beusterien, Kathleen
AU - Bridges, John F.P.
AU - Amos, Kaitlan
AU - Cardozo, Linda
N1 - Funding Information:
This study was funded by Medtronic (Minneapolis, MN). Medtronic manufactures equipment for sacral nerve stimulation, which is one of the treatment options studied.
Publisher Copyright:
© 2015, Springer Science+Business Media Dordrecht.
PY - 2015/10/1
Y1 - 2015/10/1
N2 - Objective: To evaluate patient preferences for refractory overactive bladder (OAB) treatments: sacral neuromodulation (SNM), onabotulinum toxin A (Botox®), and percutaneous tibial nerve stimulation (PTNS). Materials and methods: A cross-sectional Web survey was conducted with UK idiopathic OAB patients, recruited by a market research company. Preference was explored using direct questioning, comparing SNM, Botox, and PTNS, and via best–worst scaling (BWS). In BWS, patients prioritized subsets of 13 treatment characteristics (attributes) across 13 choice tasks, identifying the attribute they considered best and worst in each task. The attributes were those that were identified by patients in previous qualitative interviews as influential in treatment selection. BWS scores for each attribute, ranging from 1.0 (most favourable) to −1.0 (most unfavourable), were calculated based on the rates they were identified as best and as worst. To identify attributes that may influence treatment choice, BWS scores were compared among patients based on their most preferred treatment using analyses of variance; pairwise differences were assessed using Tukey’s multiple comparisons test. Results: The study population (N = 139) was 77 % female, had a mean age of 49 years, and were diagnosed a mean of 6.1 years ago. All 13 attribute BWS scores were viewed positively (score > 0.0) or negatively (score < 0.0). Among the 127 (91 %) of patients who had experience with OAB medication only, most (≥80 %) were willing to try each of the three treatments; 57, 34, and 9 % most preferred PTNS, SNM, and Botox, respectively. Preferences for the attributes differed based on which treatment that patients preferred. Specifically, patients preferring SNM (PS) favoured ‘implanted device in upper buttock’ more than those preferring PTNS (PP) or Botox (PB). Compared to PB, PS also favoured ‘sends signals between bladder and brain to help restore bladder function’ and ‘test phase’. PB favoured ‘Botox (botulinum toxin) treatment’ and ‘treatment procedure delivered through the urethra’ more than PS and PP. PP favoured the following more than PS and PB: ‘needle inserted into ankle’, ‘minimal side effects’ and ‘treatment requires repeated visits over time’. Conclusion: This study identified specific characteristics of specialized therapies for refractory OAB that may significantly influence patient preferences, which may be used to help inform treatment decision-making.
AB - Objective: To evaluate patient preferences for refractory overactive bladder (OAB) treatments: sacral neuromodulation (SNM), onabotulinum toxin A (Botox®), and percutaneous tibial nerve stimulation (PTNS). Materials and methods: A cross-sectional Web survey was conducted with UK idiopathic OAB patients, recruited by a market research company. Preference was explored using direct questioning, comparing SNM, Botox, and PTNS, and via best–worst scaling (BWS). In BWS, patients prioritized subsets of 13 treatment characteristics (attributes) across 13 choice tasks, identifying the attribute they considered best and worst in each task. The attributes were those that were identified by patients in previous qualitative interviews as influential in treatment selection. BWS scores for each attribute, ranging from 1.0 (most favourable) to −1.0 (most unfavourable), were calculated based on the rates they were identified as best and as worst. To identify attributes that may influence treatment choice, BWS scores were compared among patients based on their most preferred treatment using analyses of variance; pairwise differences were assessed using Tukey’s multiple comparisons test. Results: The study population (N = 139) was 77 % female, had a mean age of 49 years, and were diagnosed a mean of 6.1 years ago. All 13 attribute BWS scores were viewed positively (score > 0.0) or negatively (score < 0.0). Among the 127 (91 %) of patients who had experience with OAB medication only, most (≥80 %) were willing to try each of the three treatments; 57, 34, and 9 % most preferred PTNS, SNM, and Botox, respectively. Preferences for the attributes differed based on which treatment that patients preferred. Specifically, patients preferring SNM (PS) favoured ‘implanted device in upper buttock’ more than those preferring PTNS (PP) or Botox (PB). Compared to PB, PS also favoured ‘sends signals between bladder and brain to help restore bladder function’ and ‘test phase’. PB favoured ‘Botox (botulinum toxin) treatment’ and ‘treatment procedure delivered through the urethra’ more than PS and PP. PP favoured the following more than PS and PB: ‘needle inserted into ankle’, ‘minimal side effects’ and ‘treatment requires repeated visits over time’. Conclusion: This study identified specific characteristics of specialized therapies for refractory OAB that may significantly influence patient preferences, which may be used to help inform treatment decision-making.
KW - Botox
KW - Onabotulinum toxin A
KW - Patient preferences
KW - Percutaneous tibial nerve stimulation
KW - Refractory OAB treatment
KW - Sacral neuromodulation
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U2 - 10.1007/s11255-015-1100-3
DO - 10.1007/s11255-015-1100-3
M3 - Article
C2 - 26347077
AN - SCOPUS:84944150967
VL - 47
SP - 1619
EP - 1627
JO - International Urology and Nephrology
JF - International Urology and Nephrology
SN - 0301-1623
IS - 10
ER -