Drug therapy for overactive bladder (OAB) is associated with improvements in symptoms and quality of life, but the short‐ and long‐term adherence and persistence is suboptimal. In this review we outline methods of measuring, and factors affecting, adherence to pharmacotherapy in patients with OAB. Clinical practice suggests that adherence rates reported in clinical trials are much greater than in real practice. Factors affecting adherence include psychological and social variables that might alter patients’ perception of the benefits of taking medication, and the effect of comorbidity and polypharmacy. Whilst there is some evidence that lack of efficacy and side‐effects are contributory, these additional factors are also important.

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Bladder sensations experienced during cystometry are different in position and duration in relation to urodynamic diagnoses. This indicates that uniform descriptions of sensations during filling cystometry might not be appropriate to different urodynamic diagnoses.

Membership of some ethnic groups has an effect on renal transplant outcome but little is known about the impact of Indo-Asian ethnicity, despite this group's high incidence of renal disease. We compared outcomes in Indo-Asians and Caucasians at the Hammersmith Hospital (Indo-Asians, N = 46; Caucasians, N = 90), in the Long-Term Efficacy and Safety Surveillance (LOTESS) database of cyclosporin-treated renal transplant recipients (Indo-Asians, N = 254; Caucasians, N = 4262) and the National Transplant Database held by UK Transplant (Indo-Asians, N = 459; Caucasians, N = 4831). The baseline demographic and co-morbid characteristics of the two ethnic groups were comparable, save for more diabetes in the Indo-Asian community. Following transplantation, the incidence of delayed graft function and steroid-resistant acute rejection were also comparable, as were graft and patient survival (out to 5 years) and graft function. In addition, post-transplant blood pressure, levels of cholesterol and triglycerides and exposure to corticosteroids and cyclosporin were comparable. However, when patients who were not diabetic before transplantation were studied separately, there was an increased incidence of diabetes in the Indo-Asian community (Hammersmith data: Indo-Asians 10.9% vs. Caucasians 3.3%, p = 0.02; LOTESS data Indo-Asians 5.5% vs. Caucasians 1.6%, p < 0.0001). Subsequent management of this group should pursue immunosuppressive regimens less likely to impair post-transplant glucose tolerance.

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Overactive bladder (OAB) is characterised by the storage symptoms of urgency, with or without urge incontinence, and usually with urinary frequency and nocturia. OAB is a common condition that affects people of all ages within society. It has an estimated prevalence of 16% and is known to adversely affect quality of life (QOL). Assessment of the QOL of patients is important to understanding both the burden of disease and improvement after treatment. In clinical practice, the physician's assessment of the disease burden of OAB has been shown to be inaccurate and non-reproducible. Psychometrically robust self-completion questionnaires provide a valid, reproducible and rapid assessment of patient-reported disease impact that can elicit the impact of symptoms, and they are also useful for the evaluation of the efficacy of an intervention. Many different questionnaires have been developed to assess the QOL impact of OAB. Generic instruments measure very broad aspects of health and are suitable for a wide range of patient groups and general population screening. They can be applied to patients with any medical condition and provide a measure of morbidity but are less sensitive to clinically relevant change in conditions such as OAB. Condition-specific questionnaires offer greater sensitivity and responsiveness to change in the assessment of QOL of specific patient groups. Single-item global assessment questionnaires are useful in conditions such as OAB that have multiple and varied symptoms, and reflect an individual's needs, concerns and values. Patient-derived outcome measures are used in real-world clinical practice, clinical trials, health economic research and healthcare planning.

Lower urinary tract symptoms (LUTS) have a detrimental effect on quality-of-life (QoL). However, sufferers are often reluctant to seek help. Screening for LUTS will identify patients with bothersome symptoms who may benefit from treatment and allow patients to self-assess their symptoms and the need for medical intervention, potentially saving costly medical time and reducing long-term morbidity. The aim of this study was to compare the value of two validated questionnaires: the Bladder Control Self Assessment Questionnaire (B-SAQ) and the Overactive Bladder Awareness Tool (OAB-V8) as screening questionnaires in clinical practice. A total of 223 women were recruited prospectively from three centres. Participants completed both questionnaires in the waiting area prior to assessment by a clinician, who completed a symptom evaluation sheet. Data were analysed using receiver operating characteristic curves. Both the B-SAQ and the OAB-V8 performed well in detecting symptoms of OAB and mixed urinary symptoms. The B-SAQ performed better in detecting symptoms of stress incontinence than the OAB-V8. The opportunity to screen for haematuria should never be missed and this is an important omission from the OAB-V8.