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Defining success in overactive bladder management: the importance of patient‐focused outcomes
Author(s) -
Kelleher C,
Cortes E
Publication year - 2006
Publication title -
bjog: an international journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.157
H-Index - 164
eISSN - 1471-0528
pISSN - 1470-0328
DOI - 10.1111/j.1471-0528.2006.01082.x
Subject(s) - overactive bladder , medicine , quality of life (healthcare) , disease , clinical trial , physical therapy , population , clinical significance , intensive care medicine , alternative medicine , nursing , pathology , environmental health
Overactive bladder (OAB) is a common and costly condition affecting up to 16% of the adult population in Europe and the USA. OAB results in significant impairment of the quality of life (QoL) of sufferers. In clinical trials of OAB treatments, symptom measurements remain the most important primary outcome measures. Without understanding and measuring QoL, the true impact of OAB and the benefit of treatment cannot be evaluated. Many different multidimensional QoL questionnaires have been used to assess people with OAB. Generic questionnaires lack the sensitivity to detect important improvements in QoL following OAB therapies. For this reason, disease‐specific QoL measures have been developed. Disease‐specific questionnaires focus on aspects of QoL impacted by lower urinary tract symptoms. Such instruments offer far greater sensitivity, specificity, and clinical relevance to patient populations with OAB. Minimal important difference assessments have improved our understanding of the relevance of improvements in questionnaire scores. Unfortunately, the apparent complexity of QoL questionnaires has restricted their widespread use in clinical practice and to some extent in clinical trials. Short transparent patient‐perception measures and symptom bother scales are increasingly being used to fulfil this role. Short screening versions of these questionnaires have been developed to detect symptom bother and OAB‐related QoL impairment in symptomatic but currently untreated patients. Our understanding of OAB, the impairment it causes, and the benefit of treatments both to individuals and society have greatly improved through the use of validated QoL assessment tools. The questionnaires and their usage continue to evolve.