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A Retrospective Database Analysis of Anticholinergic Burden Among Older Patients With and Without Overactive Bladder in South Korea

Kyu-Sung Lee, Juhee Cho, Hyejeong Park, Danbee Kang, Kwang Jin Ko, Chee Yoong Foo, Matthias Stoelzel, Farid Abdul Hadi et al.

International Neurourology Journal, 2025

11,676 participants · 2 citations

Abstract

PURPOSE: This study aimed to measure the cumulative anticholinergic burden in older outpatients in South Korea with and without newly started overactive bladder (OAB) medications, and to assess the contribution OAB treatment-related antimuscarinics have on overall anticholinergic exposure. METHODS: This retrospective study utilizing the South Korean National Health Insurance Service database included patients ≥65 years old with ≥1 outpatient visit (any cause) between January 1 and June 30, 2016. The overall cohort included patients with OAB and matched patients without OAB. Outcomes were assessed over a 100-day follow-up period. Primary endpoints were 100-day cumulative anticholinergic cognitive burden score, prevalence of anticholinergic and strong anticholinergic use, and number of anticholinergics per patient. Proportion of anticholinergic cognitive burden score attributable to OAB medication was a secondary endpoint. RESULTS: The final study cohort included 2,360 patients with OAB and 11,676 patients without OAB. Mean 100-day cumulative anticholinergic cognitive burden score was 15.2 times higher for OAB (320.1) than non-OAB (21.0). Anticholinergics were used widely for OAB patients (2,287 [96.9%] vs. 3,921 [33.6%] non-OAB patients). Prevalence of strong anticholinergic use was almost 4 times higher for OAB (2,234 patients [94.7%]) compared with non-OAB (2,817 patients [24.1%]). On average, 0.9 anticholinergics were dispensed per patient. Anticholinergic cognitive burden…

How strong is the evidence?

Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 11,676 participants or records.

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