Misconceptions and Miscommunication Among Aging Women With Overactive Bladder Symptoms

Abstract

Objectives-With the ultimate goal of improving the quality of care provided to aging women with overactive bladder, we sought to better understand aging women's experience with overactive bladder (OAB) symptoms and the care they receive.Methods-Women seen in outpatient female urology clinics were identified by ICD-9 codes for OAB and recruited. Patients with painful bladder syndrome, mixed stress and urge incontinence, prolapse, or recent pelvic surgery were excluded. Patient focus groups were conducted by trained non-clinician moderators incorporating topics related to patients' perceptions of OAB physiology, symptoms, diagnostic evaluation, treatments, and outcomes. Qualitative data analysis was performed using grounded theory methodology.Results-Five focus groups totaling 33 women with OAB were conducted. Average patient age was 67 years (range 39-91). Older women with OAB lacked knowledge about the physiology of their disease and had poor understanding regarding the rationale for many diagnostic tests, including urodynamics and cystoscopy. The results of diagnostic studies often were not understood by older patients. Many women were dissatisfied with the care they had received. This lack of knowledge and understanding was more apparent among the elderly women in the group. Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. NIH Public Access Author ManuscriptUrology. Author manuscript; available in PMC 2012 January 1. Conclusions-Findings demonstrated a poor understanding of the physiology of overactive bladder and the rationale for various diagnostic modalities and treatments. This was associated with dissatisfaction with care. There is a need for better communication with older women experiencing OAB symptoms about the physiology of the condition.

Global perspective of treatment failures

“…[13][14][15] For example, a survey of primary-care physicians showed that these healthcare professionals failed to identify 57.5% of patients with OAB. 13 Among OAB patients, research has shown gaps in knowledge about physiology and understanding of diagnostic tests.…”

“…13 Among OAB patients, research has shown gaps in knowledge about physiology and understanding of diagnostic tests. 15 Furthermore, patient expectations about treatment have been found to be unrealistic. 15 OAB is also undertreated.…”

“…15 Furthermore, patient expectations about treatment have been found to be unrealistic. 15 OAB is also undertreated. An analysis of a large U.S. database (IMS Health) showed that only one-quarter of patients with a diagnosis of OAB are treated.…”

“…[13][14][15] For example, a survey of primary-care physicians showed that these healthcare professionals failed to identify 57.5% of patients with OAB.…”

Prevalence, management and outcomes of medically complex vulnerable elderly patients with urinary incontinence in the United States

“…Physician–patient communication is key to early and successful treatment of UI 7. However, most elderly people do not consider UI as a serious medical problem and discuss UI problems with physicians only when the disease becomes more severe 8.…”