Antimuscarinic Medication Use in Elderly Patients with Overactive Bladder.

BACKGROUND: Antimuscarinic medications are the first-line pharmacological treatment for overactive bladder (OAB); however, little is known about the utilization pattern of antimuscarinic agents in elderly patients with OAB.

OBJECTIVE: This study examined the prevalence and predictors of antimuscarinic medication prescribing in elderly patients with OAB, using national ambulatory survey data.

METHODS: This cross-sectional study utilized the 2009-2010 National Ambulatory Medical Care Survey and the outpatient component of the National Hospital Ambulatory Medical Care Survey. The study included patients aged ≥65 years diagnosed with OAB based on the International Classification of Diseases. Antimuscarinic medications were operationally defined using the American Hospital Formulary Service classification and identified using Multum Lexicon codes. Descriptive statistics using sampling weights were used to estimate the prevalence of antimuscarinic medication prescription, while multivariable logistic regression within the conceptual framework of the Anderson Behavioral Model was used to identify the factors associated with antimuscarinic medication prescription in elderly patients with OAB.

RESULTS: According to the national surveys, 2.18 million (95 % confidence interval [CI] 1.62-2.75) elderly outpatient visits were made for OAB, of which 0.90 million (41.43 %) visits involved prescribing of antimuscarinic medications. The most frequently prescribed drugs were solifenacin (14.25 %), oxybutynin (10.50 %), and tolterodine (6.89 %). Multivariable analysis revealed that patients ≥85 years of age (odds ratio [OR] 3.50, 95 % CI 1.23-9.92) were more likely to receive antimuscarinic medications, and the South region (OR 2.78, 95 % CI 1.01-7.66) increased the likelihood of receiving antimuscarinic medications in elderly patients with OAB.

CONCLUSIONS: This study found that antimuscarinic medications are commonly prescribed for elderly patients with OAB and there is variation in antimuscarinic use across age and region.