Improvement of medication adherence for desmopressin by adjusting the prescription dosage in male patients with overactive bladder: A claims database analysis.

IF 1.8 3区医学 Q3 UROLOGY & NEPHROLOGY

Neurourology and Urodynamics Pub Date : 2024-07-09 DOI:10.1002/nau.25541

Kazuna Tsubouchi, Toshiki Maeda, Taiki Emoto, Chikao Aoyagi, Wataru Matsuoka, Fumihiro Yamazaki, Chizuru Nakagawa, Yuichiro Fukuhara, Kosuke Tominaga, Naotaka Gunge, Takeshi Miyazaki, Yu Okabe, Hiroshi Matsuzaki, Nobuyuki Nakamura, Hisatomi Arima, Nobuhiro Haga

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引用次数: 0

Abstract

Objectives: Desmopressin is widely used for nocturia in patients with nocturnal polyuria. We investigated the continuation rate and adherence for desmopressin in patients with overactive bladder and nocturia using a claims database and evaluated factors that improved adherence.

Methods: Patients with nocturia in a Japanese claims database who started desmopressin between September 2019 and July 2021 were evaluated. Drug persistence was assessed using the Kaplan-Meier method for initial prescription of desmopressin. The proportion of days covered (PDC) was also evaluated among patients with prescription persistence. Multivariate analysis was performed using logistic regression analysis to identify factors predicting adherence to desmopressin.

Results: The study included 72,888 patients entered into Japan Medical Data Center (JMDC) database between September 2019 and July 2021. For the 236 patients prescribed desmopressin formulations, mean prescription duration was 114 days. Among the total cases, 90 (38.1%) cases were prescribed only once, mean PDC was 0.60, and the number of high-adherence patients (PDC ≥ 0.80) was 108 (45.8%). Desmopressin prescription doses were fixed in 216 patients and adjusted in 20 patients. Multivariate analysis identified prescription dose adjustment for desmopressin as significantly associated with high PDC.

Conclusion: Desmopressin showed a 38% dropout rate after the first dose. However, high medication continuation and high medication adherence rates (PDC) could be maintained with prescription adjustments. Careful patient monitoring and appropriate adjustment of the desmopressin dosage appear to be important factors in improving nocturia.

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通过调整膀胱过度活动症男性患者的处方剂量，改善去氨加压素的用药依从性：索赔数据库分析。

目的：去氨加压素被广泛用于治疗夜间多尿患者的夜尿症。我们利用索赔数据库调查了膀胱过度活动症和夜尿症患者继续使用去氨加压素的比率和依从性，并评估了提高依从性的因素：对日本理赔数据库中2019年9月至2021年7月期间开始使用去氨加压素的夜尿症患者进行了评估。采用卡普兰-梅耶法评估了去氨加压素初始处方的药物依从性。还评估了处方持续性患者的覆盖天数比例（PDC）。采用逻辑回归分析法进行了多变量分析，以确定预测去氨加压素依从性的因素：研究纳入了 2019 年 9 月至 2021 年 7 月期间录入日本医疗数据中心（JMDC）数据库的 72888 名患者。在开具去氨加压素处方的236名患者中，平均处方时间为114天。在所有病例中，90例（38.1%）只开过一次处方，平均PDC为0.60，高依从性患者（PDC≥0.80）为108例（45.8%）。216名患者的去氨加压素处方剂量是固定的，20名患者的处方剂量是调整的。多变量分析发现，去氨加压素处方剂量调整与高 PDC 显著相关：结论：去氨加压素首次用药后的停药率为 38%。结论：去氨加压素的首剂停药率为 38%，但调整处方后仍能保持较高的用药持续率和用药依从率（PDC）。对患者进行仔细监测并适当调整去氨加压素的剂量似乎是改善夜尿症的重要因素。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Neurourology and Urodynamics 医学-泌尿学与肾脏学

CiteScore

4.30

自引率

10.00%

发文量

231

审稿时长

4-8 weeks

期刊介绍： Neurourology and Urodynamics welcomes original scientific contributions from all parts of the world on topics related to urinary tract function, urinary and fecal continence and pelvic floor function.