Authors (including presenting author) :
Lee YM 1, Wong SW Arale 1, Chung YY 1, Cheng Elaine 2, Sha KY Edmund 2
Affiliation :
(1) Continence Nurse Clinic (2) Department of Geri-medical, United Christian Hospital, KEC, HA
Introduction :
Overactive bladder (OAB) is described by certain bladder symptoms such as urinary urgency and frequency with or without incontinence. It could wide border and have negative impact on patient’s daily living. There are several strategies to help patient to improve the condition, for example as lifestyle modification, however, for some of the cases with moderate to severe symptoms, pharmacotherapy by giving anticholinergic drugs will be considered after performing urodynamic study. By two-pronged approach, much optimality control on OAB symptoms could be achieved.
Objectives :
To review the clinical management flow and outcomes of patient’s with OAB after given anticholinergic drugs
Methodology :
Retrospective study to review patient’s data and treatment progress from Jan, 2021 to 2022. Subjective International Prostate Symptoms Score (IPSS), Overactive Bladder- V8 score (OAB-V8) and Quality of Life (QoL) on patient symptoms control were reviewed and compared the findings of objective urodynamic investigation (CMG).
Result & Outcome :
Total 30 patients (18 female and 12 male) were reviewed. The average age of female is 64.5 and male is 67.7 representatively. The patients ‘s average number of Continence Nurse Clinic visit before doing CMG is 3.3 times. It indicated patients could receive early arrangement of diagnostic investigation soon after 3 times of specialty nurse revision session which taken 20 weeks (5 months) to arrange a CMG. After CMG investigation, 57% of patients will receive medication on the same day and only 13 % of patient required additional 24.5 days for medication prescription due to cross-hospital referral and personal consideration of pharmacotherapy. For those patients received pharmacotherapy (Mainly are Oxybutynin, Tolterodine and Solifenacin), the overall IPSS score with 19% (Female) and 40% (Male) and QoL with 27% (Female) and 35% (Male) were improved. For the OAB-V8, there was 27% (Female) and 31%(Male) improvement noted. The personal perception on using the medication with 64% of patient felt satisfaction despite only 23 % of patient felt non-optimal effect. For subsequent follow up, 42.9% patients needed to increase first line Oxybutynin dosage and 14.3% patients stepped up to second line Tolterodine whereas 1.4 % patients were direct switched to third line Solifenacin. Overall, 23% patients needed to adjust around 3 times of medication in order to achieve the most satisfied condition. On the order hand, continence nurse had monitored the common side effect of the anticholinergic drugs such as dry mouth (67%), constipation (3.3%) and retention of urine (6.7%) which subsequent nursing management to alleviate those problems were provided accordingly.For treating patients with OAB, it required patience to go through the journey from assessment, investigation, treatment and evaluation. By vigilance the treatment progress and outcomes, more precise patient management could be done.
