A population‐based study of urinary symptoms and incontinence: the Canadian Urinary Bladder Survey

Herschorn, Sender; Gajewski, Jerzy; Schulz, Jane; Corcos, Jacques

doi:10.1111/j.1464-410x.2007.07198.x

Cited by 111 publications

(93 citation statements)

References 24 publications

(91 reference statements)

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“…24 A Canada-wide telephone survey conducted in 2002 found that 49% of the 275 men aged 41 and older who were interviewed reported at least one urinary symptom, including nocturia, urgency, frequency or incontinence. 25 Neglecting to measure baseline function in these areas may overestimate the effects of RP and RT. However, our study showed that even poor function at baseline can worsen after treatment.…”

mentioning

confidence: 99%

Utility and health-related quality of life in prostate cancer patients 12 months after radical prostatectomy or radiation therapy

Krahn

Bremner

Tomlinson

et al. 2009

Prostate Cancer Prostatic Dis

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This study aims to examine and compare changes in quality of life after two common treatments for prostate cancer (PC), radical prostatectomy (RP) and radiation therapy (RT). Patients newly diagnosed with localized PC, scheduled to receive RP (n ¼ 68) or RT (n ¼ 66), completed three cancer/PC-specific psychometric instruments and three PC-specific utility instruments before treatment, and 2 and 12 months after treatment. We assessed the magnitude and time course of changes in psychometric and utility measures, and differences between treatments. The results showed that RP was associated with significant urinary and sexual dysfunction; RT caused bowel problems. Fatigue and pain were common to both. RP patients reported more problems with physical, role and social function. Utilities decreased significantly after both treatments. Effects were most severe 2 months post treatment, and then showed some recovery, but many endured for 1 year. After 1 year, 30-60% of patients had utility scores that were clinically significantly worse than at baseline. Secondary androgen deprivation therapy also significantly decreased psychometric and utility measures of quality of life. Many adverse symptoms reported 2 months after RP and RT endure for 1 year. Despite different symptom profiles, RP and RT result in similar utility decrements.

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mentioning

confidence: 99%

Utility and health-related quality of life in prostate cancer patients 12 months after radical prostatectomy or radiation therapy

Krahn

Bremner

Tomlinson

et al. 2009

Prostate Cancer Prostatic Dis

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“…2 Two large surveys have also been conducted in Canada, showing prevalence rates of 12-18%. 3,4 OAB has a substantial negative impact on patients' health-related quality of life (HRQoL) and mental health. 5 The cardinal symptoms -urgency with or without incontinence, usually associated with frequency, and nocturia 6 interfere with basic activities of daily living, such as work, travel, sleep, interpersonal activities, sexual function, and physical activities.…”

Section: Introductionmentioning

confidence: 99%

Cost-effectiveness of mirabegron compared to tolterodine ER 4 mg for overactive bladder in Canada

Herschorn¹,

Nazir²,

Ramos³

et al. 2017

CUAJ

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Introduction: This analysis compared the cost-effectiveness of once-daily regimens of mirabegron 50 mg and generic tolterodine ER 4 mg in a hypothetical cohort of previously treated patients with overactive bladder (OAB) in Canada. Methods: A Markov model was developed to represent different health states according to OAB symptoms (frequency, incontinence), presence/absence of adverse events (AEs; dry mouth, constipation, blurred vision), and treatment status (on-treatment, discontinue treatment, restart previous treatment). The time horizon used was one year, with monthly transitions between health states. The model was populated using data from a phase 3, placebo-controlled trial of mirabegron that included tolterodine as an active comparator (SCORPIO), as well as other published literature and expert opinion. Cost-effectiveness was calculated from Canadian public payer (based on Quebec list prices) and societal perspectives. Results: The incremental one-year cost per patient for mirabegron over tolterodine was $182 CAD and $157 CAD from the payer and societal perspectives, respectively. The incremental quality-adjusted life year (QALY) gain for mirabegron was 0.0066 when using EQ-5D health-state utilities. Mirabegron was cost-effective compared with tolterodine, from both payer and societal perspectives, and remained cost-effective vs. tolterodine across the majority of sensitivity analyses. The model was based on limited clinical trial evidence supplemented with expert opinion and assumptions; a select number of OAB symptoms, AEs, and direct and indirect medical costs associated with OAB; and a timeframe of only one year. Conclusions: From the payer and societal perspectives, the health economic model indicates that in Canada, mirabegron is a cost-effective treatment strategy compared with tolterodine, leading to improved health outcomes (QALYs) at an acceptable incremental cost. IntroductionOveractive bladder (OAB) is a bothersome condition with a relatively high prevalence in the general population. In a survey of over 16 500 subjects aged ≥40 years in six European countries, the prevalence of OAB was 16.6%.1 In a subsequent survey of over 19 000 subjects aged ≥18 years in Canada and Europe, the prevalence of OAB was 11.8%. OAB has a substantial negative impact on patients' health-related quality of life (HRQoL) and mental health. 5The cardinal symptoms -urgency with or without incontinence, usually associated with frequency, and nocturia 6 -interfere with basic activities of daily living, such as work, travel, sleep, interpersonal activities, sexual function, and physical activities. 7,8 Studies have often focused specifically on the impact of incontinence, but it has been shown that frequency and urgency, which are more prevalent, are as bothersome as urgency incontinence.1 In terms of mental health, it is estimated that approximately one-third of men and women with lower urinary tract symptoms may have comorbid clinical anxiety and/or depression. 9 In addition, it has been shown that the prevale...

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“…3 About 12% to 18% of Canadians live with some form of OAB, with prevalence figures of about 3.1% in men and 14.7% in women; however, these figures fail to account for the underdiagnosed problem of incontinence. [4][5][6] The pathology of the disorder suggests a disruption of the spinal reflex mechanism that carries sensory signals from autonomic and somatic pathways from the bladder outlet and tonic inhibitory system in the brain. 7 This disruption creates inhibits the control function of the parasympathetic excitatory outflow of the urinary bladder.…”

Section: Introductionmentioning

confidence: 99%

“…7 This disruption creates inhibits the control function of the parasympathetic excitatory outflow of the urinary bladder. 5 OAB can have substantial impact on a patient's quality of life, such as decreased work productivity, sexual dissatisfaction, erectile dysfunction, depression, poorer mental health, and lack of sleep. 3,8 These can adversely affect a person's physical and psychological well-being by limiting daily activities, intimacy, and worsening self-esteem.…”

Section: Introductionmentioning

confidence: 99%

Economic evaluation of sacral neuromodulation in overactive bladder: A Canadian perspective

Hassouna

Sadri

2015

CUAJ

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Introduction: Refractory overactive bladder (OAB) with urge incontinence is an underdiagnosed condition with substantial burden on the healthcare system and diminished patient's quality-of-life. Many patients will fail conservative treatment with optimized medical-therapy (OMT) and may benefit from minimally invasive procedures, including sacral-neuromodulation (SNM) or botulinum-toxin (BonT-A). The goal of this study was to estimate the costefectiveness of SNM vs. OMT and BonT-A as important parameters from coverage and access to a therapy. Methods: A Markov model with Monte-Carlo simulation was used to assess the incremental cost effectiveness ratio (ICER) of SNM vs. BonT-A and OMT both in deterministic and probabilistic analysis from a provincial payer perspective over a 10-year time horizon with 9-month Markov-cycles. Clinical data, healthcare resource utilization, and utility scores were acquired from recent publications and an expert panel of 7 surgeons. Cost data (2014-Dollars) were derived from provincial health insurance policy, drug benefit formulary, and hospital data. All cost and outcomes were discounted at a 3% rate. Results: The annual (year 1-10) incremental quality-adjusted life years for SNM vs. BonT-A was 0.05 to 0.51 and SNM vs. OMT was 0.19 to 1.76. The annual incremental cost of SNM vs. BonT-A was $7237 in year 1 and -$9402 in year 10 and was between $8878 and -$11 447 vs. OMT. In the base-case deterministic analysis, the ICER for SNM vs. BonT-A and OMT were within the acceptable range ($44 837 and $15 130, respectively) at the second year of therapy, and SNM was dominant in consequent years. In the basecase analysis the probability of ICER being below the acceptability curve (willingness-to-pay $50 000) was >99% for SNM vs. BonT-A at year 3 and >95% for OMT at year 2. Conclusion: SNM is a cost-effective treatment option to manage patients with refractory OAB when compared to either BonT-A or OMT. From a Canadian payers' perspective, SNM may be considered a first-line treatment option in management of patients with OAB with superior long-term outcomes. Similar to all economic analysis, this study has limitations which are based on the assumptions of the used model.

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A population‐based study of urinary symptoms and incontinence: the Canadian Urinary Bladder Survey

Cited by 111 publications

References 24 publications

Utility and health-related quality of life in prostate cancer patients 12 months after radical prostatectomy or radiation therapy

Utility and health-related quality of life in prostate cancer patients 12 months after radical prostatectomy or radiation therapy

Cost-effectiveness of mirabegron compared to tolterodine ER 4 mg for overactive bladder in Canada

Economic evaluation of sacral neuromodulation in overactive bladder: A Canadian perspective

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