Treatment Persistence and Adherence with Overactive Bladder Medications in Taiwan: A Retrospective Database Analysis
Abstract
Background: Overactive bladder (OAB) is commonly treated with mirabegron or antimuscarinics, but real-world evidence on treatment persistence, adherence, and fall/fracture outcomes in Taiwan remains limited.
Objective: To assess treatment persistence, adherence, and associated outcome rates of falls/fractures, in patients receiving OAB treatment with mirabegron or antimuscarinics in Taiwan.
Design setting and participants: Retrospective, longitudinal, observational study of routine clinical practice within the Taiwanese National Health Insurance Research Database. Eligibility: age ≥20 years; ≥1 dispensing for a new OAB index drug (January 1, 2012 to December 31, 2018); continuous enrollment 1 year before and after index prescription date.
Intervention: OAB Treatment with mirabegron or antimuscarinics.
Outcome measurements and statistical analysis: Primary endpoint: treatment persistence (time to discontinuation [TTD] or switch) and adherence (proportion of days covered [PDC]); secondary endpoint: incidence of falls/fractures. Multivariate Cox proportional hazards analyses were applied to estimate adjusted hazard ratios (aHRs) with 95% confidence intervals (CIs), describing associations between treatment groups and outcomes.
Results and limitations: Overall, 1,954,544 patients were eligible (median age 60 years). Median (interquartile range [IQR]) TTD was longer with mirabegron (56 [19-168] days) than antimuscarinics (14 [5-42] days) (risk of discontinuation aHR 1.58 [95% CI…
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