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Older People’s Preferences for Side Effects Associated with Antimuscarinic Treatments of Overactive Bladder: A Discrete-Choice Experiment

Drugs & Aging volume 34, pages 615–623 (2017)Cite this article

Abstract

Introduction

Understanding the importance older people attribute to the different side effects associated with oral antimuscarinic treatments for overactive bladder (OAB) could help inform prescribers, healthcare policy makers and the drug industry.

Objective

Our objective was to quantify the importance of the most prevalent cognitive and side effects of oral antimuscarinic treatments for OAB in older people.

Methods

We conducted a discrete-choice experiment (DCE) with the assistance of an interviewer with community-dwelling and hospitalized older people aged >65 years. The DCE involved two hypothetical drugs for imaginary OAB, with three levels of four side effects for each drug, and the International Consultation on Incontinence Questionnaire–Overactive Bladder and EuroQol 5-Dimensions (EQ-5D) questionnaire were also administered. Data were analysed using a conditional logit model.

Results

In total, 276 older people participated in the study. The median age was 75 years (interquartile range [IQR] 69–80), 63% were women and 21% had OAB syndrome. The most unwanted side effect in the choice of antimuscarinics for OAB was severe cognitive effects, followed by severe constipation, severe blurred vision, severe dry mouth, moderate cognitive effects and moderate constipation. Severe cognitive effects were at least 1.7 times as important as severe constipation. Exploratory subgroup analysis showed that none of the attributes was found to be significant in people who scored as anxious or depressed on the EQ-5D, and preferences about cognitive effects, constipation and blurred vision were equal in people with and without OAB.

Conclusion

Older people attribute more importance to loss of cognitive function as a possible side effect of antimuscarinic treatment than to the three most prevalent possible side effects of this treatment.

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Acknowledgements

The authors thank the nursing students of the Department of Education, Health and Social work of University College Ghent, Inge Ragolle for assistance with the data collection and Thibaut Van Rompuy for language editing and proofreading.

Author information

Affiliations

  1. Department of Medical Sciences, Ghent University, De Pintelaan 185, 9000, Ghent, Belgium

    Veerle H. Decalf

  2. Department Education, Health and Social work, University College Ghent, Keramiekstraat 80, 9000, Ghent, Belgium

    Anja M. J. Huion

  3. Department of Marketing, Ghent University, Tweekerkenstraat 2, 9000, Ghent, Belgium

    Dries F. Benoit

  4. Department of Urology, Ghent University Hospital, De Pintelaan 185, 9000, Ghent, Belgium

    Marie-Astrid Denys & Karel C. M. M. Everaert

  5. Department of Geriatrics, Ghent University Hospital, De Pintelaan 185, 9000, Ghent, Belgium

    Mirko Petrovic

Authors
  1. Veerle H. Decalf
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  2. Anja M. J. Huion
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  3. Dries F. Benoit
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  4. Marie-Astrid Denys
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  6. Karel C. M. M. Everaert
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Corresponding author

Correspondence to Veerle H. Decalf.

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Funding

This study was supported by Eurocept with an unrestricted research grant.

Conflict of interest

Veerle Decalf, Anja Huion, Dries Benoit and Mirko Petrovic have no conflicts of interest. Marie-Astrid Denys has received educational grants from Astellas, Allergan, Bard, Ferring and Medtronic. Karel Everaert has received research, educational and travel grants, donations and honoraria from Allergan, Astellas, Eurocept, Ferring and Medtronic.

Research involving human participants

The protocol, informed consent form and other information given to participants were reviewed by the Ethics Committee of Ghent University Hospital (2015/0421). The study was conducted according to the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Decalf, V.H., Huion, A.M.J., Benoit, D.F. et al. Older People’s Preferences for Side Effects Associated with Antimuscarinic Treatments of Overactive Bladder: A Discrete-Choice Experiment. Drugs Aging 34, 615–623 (2017). https://doi.org/10.1007/s40266-017-0474-6

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  • DOI: https://doi.org/10.1007/s40266-017-0474-6