Treatment compliance of working persons to high-dose antimuscarinic therapies: a randomized trial

摘要

The aim of this work was to study the factors affecting the stability of working patients in antimuscarinic (AM) drug treatment. The prevalence of urge urinary incontinence (UUI) is an average of between 8.2% and 16.0% of the population. UUI is a condition that adversely affects the health-related quality of life. The first-line therapy in managing UUI is AM treatment. In 1006 patients between 18 and 60 years old (627 women, 379 men, mean age 69.4) who received AM treatment for one year, the possible demographic, socioeconomic and health factors influencing compliance were studied. Also, the functional state of the lower urinary tract (LUT) was studied in this randomized, prospective survey. The study instruments were the documents of employers, tax offices, outpatient records, OABq-SF (overactive bladder - short form) questionnaires, MOS SF-36 (Medical Outcomes Study short form-36), voiding charts, and uroflowmetry data. The compliance to AM treatment within 6 months was retained in 49.5% patients; during the year, in 32.3% of patients. The average time for reaching the 30-day break in taking trospium was 194 days. In the course of the experiment it was revealed that compliance to AM treatment was significantly higher in patients taking solifenacin and trospium in high dosages (p ? 0.01, p ? 0.05), suffering from severe symptoms of urgency (p ? 0.01), and having a low level of side effects (p ? 0.01). A satisfactory level of compliance is characteristic of patients with a high level of monthly and annual income (p ? 0.01, p ? 0.01), a low percentage of expenses to AM (p ? 0.05), and rarely changing employers (p ? 0.05). In addition, the compliance to treatment is higher in older adults (p ? 0.05), living in the urban district (p ? 0.01), and working in educational (p ? 0.05) and health (p ? 0.01) institutions, having a high level of the indices of Social Functioning (p ? 0.05), Role-Emotional (p ? 0.05), and Mental Health (p ? 0.01). As a result of this study, under the control of the objective functional state of LUT, the influence of various factors on the patients’ stability in the treatment with AM drugs was revealed.