Elsevier

Urology

Volume 80, Issue 1, July 2012, Pages 90-96
Urology

Health Outcomes Research
Effect of Bothersome Overactive Bladder Symptoms on Health-related Quality of Life, Anxiety, Depression, and Treatment Seeking in the United States: Results From EpiLUTS

https://doi.org/10.1016/j.urology.2012.04.004Get rights and content

Objective

To determine the bother associated with overactive bladder (OAB) symptoms and its influence on health-related quality of life (HRQL), anxiety, depression, and treatment seeking in adults in the United States.

Methods

Data from U.S. respondents aged ≥40 years participating in the Epidemiology of Lower Urinary Tract Symptoms survey, a population-based, cross-sectional Internet survey, were analyzed to assess OAB prevalence, OAB-associated bother, and effect of OAB on HRQL, anxiety, depression, and healthcare use. Likert data were categorized as no/minimal OAB symptoms, OAB without bother, and OAB with bother at least “somewhat.”

Results

Of 31 588 completed surveys, 20 000 participants (9416 men and 10 584 women) were randomly selected and matched to U.S. census demographics. Of the respondents with OAB at least “sometimes,” the women were more likely than the men to be bothered by OAB, with 68% of the women and 60% of the men bothered at least “somewhat.” Men and women with OAB with bother were more likely to report that their bladder condition caused at least some problems; had worse scores on HRQL, anxiety, and depression assessments; and had the greatest number of healthcare visits annually compared with those with OAB without bother and those with no/minimal symptoms. The strongest correlation between bother and symptom frequency was seen for urinary urgency, followed by urgency urinary incontinence and nocturia.

Conclusion

OAB symptoms can be quite bothersome, especially for women, and can negatively affect HRQL, increase anxiety and depression, and increase healthcare usage. In the present study, the strongest predictor of OAB-associated bother was urinary urgency.

Section snippets

Study Design and Participants

EpiLUTS is a population-based, cross-sectional Internet survey conducted in the United Kingdom, Sweden, and the United States to evaluate the prevalence, bother, and effect of OAB and other lower urinary tract symptoms (LUTS).10 Only the U.S. results are reported in the present study; the results on the burden of OAB symptoms in the United Kingdom and Sweden11 and across the total population12 have been previously published.

Participants were recruited from Internet-based panels developed from

Results

From approximately 1.5 million potential participants, 62 301 were randomly selected and sent electronic mail invitations. Responses were received from 36 821 participants, of whom 31 588 completed the survey. To address the overabundance of younger respondents in the eligible surveys relative to the target population, 20 000 surveys (9416 men and 10 584 women) were randomly selected for statistical matching to the 2005 American Community Survey demographics13 to ensure population

Comment

Patients with OAB must cope with symptoms of urgency, frequency, UUI, and nocturia on a daily and, perhaps, lifelong basis, given the chronic nature of OAB. A large proportion of patients with OAB are bothered by these symptoms. Numerous population studies have described the effect of OAB and UUI on bother and HRQL.20 Unlike many previous studies on the prevalence and effect of OAB, the present analysis differentiated between those with bothersome OAB symptoms and those with OAB symptoms that

Conclusions

Data from the EpiLUTS survey indicate that the burden of OAB symptoms on men and women in the United States is considerable. The strongest predictor of OAB-associated bother was urinary urgency. Although not all those with OAB were bothered by their symptoms, for those who are, the worsening of HRQL and increase in anxiety and depression can be significant.

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  • Cited by (0)

    Financial Disclosure: I. Milsom is a scientific consultant for Pfizer and United BioSource; an investigator for Pfizer and Astellas; a lecturer for Pfizer, Astellas, and Novartis; and receives grant support from Pfizer and Astellas. S. A. Kaplan is a consultant and member of the Speakers Bureau for Pfizer. K. S. Coyne and C. C. Sexton are employees of United BioSource Corporation, who were paid consultants to Pfizer in connection with the development of this report. Z. Kopp was an employee of Pfizer at the time this study was conducted.

    Funding Support: This study was sponsored by Pfizer, Inc. Medical writing support was provided by Colin P. Mitchell, Ph.D., and Karen Zimmermann at Complete Healthcare Communications, Inc., and was funded by Pfizer, Inc.

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