Factors Influencing Treatment Strategy for Overactive Bladder in the National Institute of Health All of Us Research Program.

Abstract

Importance: Overactive bladder (OAB) is a condition characterized by urinary urgency, frequency, and incontinence, affecting up to 43% of women. While treatment disparities are well-documented, this study sheds light on broader systemic barriers and the need for equitable approaches to improve diagnosis and management.

Objective: This study aimed to examine the types of OAB treatments (no treatment, pharmacotherapy, advanced therapy) received by patients in the United States, stratified by race, ethnicity, and socioeconomic factors, using data from the All of Us Research Hub.

Study design: Data were collected from 20,941 female patients diagnosed with OAB in the All of Us Research Hub. Patients were categorized into 3 treatment groups: (1) no treatment, (2) pharmacotherapy, or (3) advanced therapy. Demographic factors such as race, ethnicity, age, income, and health status were analyzed using univariate and multivariate logistic regression models to determine the influence on treatment type.

Results: Of the participants, 71% received no treatment, 27% were treated with pharmacotherapy, and 2% underwent advanced therapy. On multivariate analysis, Asian and Hispanic patients were less likely to receive pharmacotherapy compared to White patients (odds ratio (95% CI), 0.47 (0.31-0.72) and 0.84 (0.74-0.95) respectively). Additionally, factors such as increasing age, unemployment, and lower income were associated with greater odds of receiving pharmacotherapy.

Conclusions: Significant differences exist in the treatment of OAB, particularly among Asian and Hispanic patients. Socioeconomic factors and self-reported health status also affect access to treatment. Addressing these disparities is crucial to improving health care equity and access for patients with OAB.