The effects of drug and behavior therapy on urgency and voiding frequency
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Introduction and hypothesis
The objective of this study was to examine the effects of drug therapy alone and combined with behavioral therapy on urgency and 24-voiding frequency in women with urge-predominant incontinence and to identify predictors of change.
A planned analysis of data from a multi-site, randomized, controlled trial (N = 307). Bladder diaries were used to document voids, incontinence, and urgency severity.
Urgency scores decreased significantly within both treatment groups, but changes did not differ between groups (p = 0.30). Improvement in urgency was associated with greater baseline urgency (p < 0.0001) and black ethnicity (p = 0.03). Voiding frequency increased with drug alone and decreased slightly with combined therapy (p = 0.009), and improvement was associated with combined treatment (p < 0.0001), higher baseline frequency (p < 0.0001), and lower baseline incontinence episode frequency (p = 0.001).
Although combined drug and behavioral therapy does not appear to improve urgency more than drug alone, it resulted in better outcomes on voiding frequency.
KeywordsBehavioral treatment Drug therapy Overactive bladder Urge incontinence Urinary frequency Urinary urgency
This study was supported by grants from the National Institute of Diabetes and Digestive and Kidney Diseases (U01 DK 58225, U01 DK58234, U01 DK58229, U01 DK58231, U01 DK60397, U01 DK60401, U01 DK60395, U01 DK60393, U01 DK60380, U01 DK60379). Pfizer, Inc. provided additional support, including donation of study drugs and funding.
Conflicts of interest
Four of the authors have a financial relationship with Pfizer. Kathryn L. Burgio: Pfizer (consultant, research grant), Astellas (advisory board); Stephen R. Kraus: Lilly (consultant, research grant), Pfizer (consultant, speaker), Novartis (speaker); Diane Borello-France: none; Toby C. Chai: Pfizer (consultant), Allergan (consultant); Kimberly Kenton: none; Patricia S. Goode: Pfizer (research grant); Yan Xu: none; John W. Kusek: none.
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