Insights from the AQUA Registry: a retrospective study of anticholinergic polypharmacy in the United States.

IF 2.6 4区 医学 Q2 UROLOGY & NEPHROLOGY
Matthew R Cooperberg, Rachel Mbassa, David Walker, William Meeks, Amy Lockefeer, Baoguo Jiang, Tina Li, Karissa Johnston, Raymond Fang
{"title":"Insights from the AQUA Registry: a retrospective study of anticholinergic polypharmacy in the United States.","authors":"Matthew R Cooperberg,&nbsp;Rachel Mbassa,&nbsp;David Walker,&nbsp;William Meeks,&nbsp;Amy Lockefeer,&nbsp;Baoguo Jiang,&nbsp;Tina Li,&nbsp;Karissa Johnston,&nbsp;Raymond Fang","doi":"10.1177/17562872221150572","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Anticholinergic (ACH) burden is a risk factor for negative health outcomes among older adults. Several medications contribute to ACH burden, including antimuscarinics used to manage overactive bladder (OAB).</p><p><strong>Objectives: </strong>This study aimed to understand the extent of ACH burden in an OAB population in the United States.</p><p><strong>Design: </strong>Non-interventional retrospective analysis.</p><p><strong>Methods: </strong>Adults with OAB whose care providers participated in the American Urological Association Quality (AQUA) Registry between 2014 and 2020 were included in this study. An adapted version of the Pharmacy Quality Alliance (PQA) measure of anticholinergic polypharmacy (poly-ACH) was used to assess ACH burden. The primary outcome was the annual prevalence of poly-ACH, and a secondary outcome was the percentage of patients taking 0, 1, 2, 3, 4, or ⩾ 5 ACH medications by calendar year. Analyses were stratified by age category at diagnosis and sex.</p><p><strong>Results: </strong>The sample comprised 552,840 patients with OAB. The mean age at initial OAB diagnosis was 65.7 years (58.2% male; 57.4% white). Prevalence of poly-ACH was highest in 2015 (3.7%) and lowest in 2020 (1.9%). Patients prescribed no ACH medications made up the largest proportion of each cohort, while those prescribed five or more comprised the smallest. The trend of decreasing proportions of patients taking increasing numbers of ACH medications was consistent. The proportion of patients prescribed no ACH medications increased from 63.3% in 2014 to 74.6% in 2020. The percentage of those prescribed three or more ACHs remained largely unchanged. Poly-ACH was highest among younger individuals (< 65 years of age) and females; temporal trends were similar overall and within each age and sex stratum.</p><p><strong>Conclusion: </strong>In this study, poly-ACH in patients with OAB was relatively infrequent and decreased over the study period. Further evaluation of poly-ACH is needed to assess whether the study findings reflect increased awareness of the negative effects of poly-ACH.</p>","PeriodicalId":23010,"journal":{"name":"Therapeutic Advances in Urology","volume":null,"pages":null},"PeriodicalIF":2.6000,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/8f/59/10.1177_17562872221150572.PMC9871979.pdf","citationCount":"1","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Therapeutic Advances in Urology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1177/17562872221150572","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"UROLOGY & NEPHROLOGY","Score":null,"Total":0}
引用次数: 1

Abstract

Background: Anticholinergic (ACH) burden is a risk factor for negative health outcomes among older adults. Several medications contribute to ACH burden, including antimuscarinics used to manage overactive bladder (OAB).

Objectives: This study aimed to understand the extent of ACH burden in an OAB population in the United States.

Design: Non-interventional retrospective analysis.

Methods: Adults with OAB whose care providers participated in the American Urological Association Quality (AQUA) Registry between 2014 and 2020 were included in this study. An adapted version of the Pharmacy Quality Alliance (PQA) measure of anticholinergic polypharmacy (poly-ACH) was used to assess ACH burden. The primary outcome was the annual prevalence of poly-ACH, and a secondary outcome was the percentage of patients taking 0, 1, 2, 3, 4, or ⩾ 5 ACH medications by calendar year. Analyses were stratified by age category at diagnosis and sex.

Results: The sample comprised 552,840 patients with OAB. The mean age at initial OAB diagnosis was 65.7 years (58.2% male; 57.4% white). Prevalence of poly-ACH was highest in 2015 (3.7%) and lowest in 2020 (1.9%). Patients prescribed no ACH medications made up the largest proportion of each cohort, while those prescribed five or more comprised the smallest. The trend of decreasing proportions of patients taking increasing numbers of ACH medications was consistent. The proportion of patients prescribed no ACH medications increased from 63.3% in 2014 to 74.6% in 2020. The percentage of those prescribed three or more ACHs remained largely unchanged. Poly-ACH was highest among younger individuals (< 65 years of age) and females; temporal trends were similar overall and within each age and sex stratum.

Conclusion: In this study, poly-ACH in patients with OAB was relatively infrequent and decreased over the study period. Further evaluation of poly-ACH is needed to assess whether the study findings reflect increased awareness of the negative effects of poly-ACH.

Abstract Image

Abstract Image

Abstract Image

AQUA登记处的见解:美国抗胆碱能综合用药的回顾性研究。
背景:抗胆碱能(ACH)负担是老年人不良健康结局的危险因素。几种药物有助于乙酰胆碱负担,包括用于治疗膀胱过动症(OAB)的抗毒蕈素。目的:本研究旨在了解美国OAB人群ACH负担的程度。设计:非干预性回顾性分析。方法:本研究纳入了2014年至2020年期间护理人员参加美国泌尿协会质量(AQUA)登记处的成年OAB患者。采用药房质量联盟(PQA)抗胆碱能多药(poly-ACH)测量的改编版本来评估ACH负担。主要结果是poly-ACH的年度患病率,次要结果是按日历年服用0、1、2、3、4或大于或小于5 ACH药物的患者的百分比。分析按诊断时的年龄和性别进行分层。结果:样本包括552,840例OAB患者。OAB初始诊断的平均年龄为65.7岁(58.2%为男性;57.4%的白人)。poly-ACH患病率最高的是2015年(3.7%),最低的是2020年(1.9%)。在每个队列中,未服用乙酰胆碱类药物的患者所占比例最大,而服用五种或五种以上药物的患者所占比例最小。服用乙酰胆碱药物数量增加的患者比例下降的趋势是一致的。未使用乙酰氨基酚类药物的患者比例从2014年的63.3%上升到2020年的74.6%。处方三种或三种以上乙酰氨基酚类药物的比例基本保持不变。Poly-ACH在年轻人中最高(结论:在本研究中,OAB患者的Poly-ACH相对较少,并且在研究期间呈下降趋势。需要对聚乙酰胆碱进行进一步的评估,以评估研究结果是否反映了人们对聚乙酰胆碱的负面影响的认识增加。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
CiteScore
3.70
自引率
0.00%
发文量
39
审稿时长
10 weeks
期刊介绍: Therapeutic Advances in Urology delivers the highest quality peer-reviewed articles, reviews, and scholarly comment on pioneering efforts and innovative studies across all areas of urology. The journal has a strong clinical and pharmacological focus and is aimed at clinicians and researchers in urology, providing a forum in print and online for publishing the highest quality articles in this area. The editors welcome articles of current interest across all areas of urology, including treatment of urological disorders, with a focus on emerging pharmacological therapies.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信