Shifting the treatment paradigm in idiopathic overactive bladder

Sahai, Amit; Belal, Mo; Hamid, Rizwan; Toozs‐Hobson, Philip; Granitsiotis, Paraskeve; Robinson, Dudley

doi:10.1111/ijcp.13847

Cited by 4 publications

(8 citation statements)

References 63 publications

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“…Several innovative paradigms and analytic methods have been applied to this problem; some improve on the current tier-based approach while others argue for a shift towards individualized care. 25,26 There is emerging data to predict response to pharmacotherapy and evaluating best options for patients based on various criteria. [27][28][29] A model to predict the individual treatment response of fesoterodine was created in 2016.…”

Section: Personalized Oab Carementioning

confidence: 99%

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Delivering patient‐centered care through shared decision making in overactive bladder

Paudel

Lane

2022

Neurourology and Urodynamics

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Introduction Men and women living with overactive bladder (OAB) face many treatment decisions as they progress through the treatment pathway. Decisions to pursue specific therapies are highly preference sensitive and ideal for shared decision making (SDM). The aim of this narrative review is to provide urologists with a practical summary of methods to elicit preferences and facilitate SDM to promote patient‐centered care for OAB. Methods We explore OAB as a preference sensitive condition through a review of treatment outcomes and present available data on prediction tools, patient preferences, and decision aids. We propose a paradigm for applying Everyday SDM to OAB care. Results Clinical outcome data points to equipoise (balanced outcomes) between options for first‐, second‐, and third‐line OAB therapies, making OAB preference sensitive and appropriate for SDM. Methods to personalize care through individualized outcome prediction calculators and tools to elicit patient preferences are emerging. While patient information about OAB is readily available, we identified few OAB decision aids that facilitate patient preference elicitation and SDM. Conclusions OAB is a preference sensitive condition, where treatment is largely based on the patient's preferences and values. SDM is an ideal approach to supporting patients through these treatment decisions. We propose the application of Everyday SDM, a personalized, clinically efficient methodology as a method to support patient‐centered OAB care.

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Section: Personalized Oab Carementioning

confidence: 99%

“…How can clinicians make personalized recommendations to guide Everyday SDM ? Several innovative paradigms and analytic methods have been applied to this problem; some improve on the current tier‐based approach while others argue for a shift towards individualized care 25,26 …”

Section: Personalized Oab Carementioning

confidence: 99%

Delivering patient‐centered care through shared decision making in overactive bladder

Paudel

Lane

2022

Neurourology and Urodynamics

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“…SNM is another minimally invasive procedure; however, it needs an experimental period to assess the effectiveness until a permanent pulse generator is implanted. Also, the increased economic cost of this approach may represent a big challenge for some patients [6].…”

Section: Introductionmentioning

confidence: 99%

Efficacy and safety of tibial nerve stimulation using a wearable device for overactive bladder

Liao,

Li,

Chong

et al. 2024

BJU International

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ObjectiveTo evaluate the efficacy and safety of a wearable, smartphone‐controlled, rechargeable transcutaneous tibial nerve stimulation (TTNS) device in patients with overactive bladder (OAB).Patients and MethodsThis multicentre, prospective, single‐blind, randomised clinical trial included eligible patients with OAB symptoms who were randomly assigned to the stimulation group or sham group. The primary efficacy outcome was change from baseline in voiding frequency/24 h after 4 weeks of treatment. The secondary efficacy outcomes included changes in bladder diary outcomes (urgency score/void, nocturia episodes/day, micturition volume/void, and incontinence episodes/day), questionnaires on Overactive Bladder Symptom Score (OABSS), Patient Perception of Bladder Condition (PPBC), and American Urological Association Symptom Index Quality of Life Score (AUA‐SI‐QoL) at baseline and after 4 weeks of treatment. Device‐related adverse events (AEs) were also evaluated.ResultsIn the full analysis set (FAS), the mean (sd) change of voiding frequency/24 h in the stimulation group and sham group at 4 weeks were −3.5 (2.9) and −0.6 (2.4), respectively (P < 0.01). Similar results were obtained in the per‐protocol set (PPS): −3.5 (2.9) vs −0.4 (2.3) (P < 0.01). In the FAS and PPS, micturition volume/void significantly improved at 4 weeks (P = 0.01 and P = 0.02). PPBC improvement almost reached significance in the FAS (P = 0.05), while it was significant in the PPS (P = 0.02). In the FAS and PPS, AUA‐SI‐QoL significantly improved at 4 weeks in the two groups (P < 0.01 and P < 0.01), whereas there were no significant differences in urgency score/void, nocturia episodes/day or OABSS between the groups. Also, no device‐related serious AEs were reported.ConclusionsThe non‐invasive neuromodulation technique using the novel ambulatory TTNS device is effective and safe for treating OAB. Its convenience and easy maintenance make it a new potential home‐based treatment modality. Future studies are warranted to confirm its longer‐term efficacy.

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“…Although the persistence rates for OAB medication improved with the introduction of mirabegron, recent studies showed that the 12-month persistence is 24–41% [ 6 ]. According to the current clinical guidelines, peripheral neuromodulation of the somatic nerves of the lower limb or sacral neuromodulation can be offered to the patients who failed previous first-line therapy [ 7 ]. Percutaneous tibial nerve stimulation (PTNS) is the most widely used peripheral neuromodulation method for the treatment of OAB in clinical practice [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

Peroneal Electric Transcutaneous NeuroModulation (eTNM®): A Novel Method for the Treatment of the Overactive Bladder

Krhút

Peter

Rejchrt

et al. 2021

Journal of Healthcare Engineering

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Overactive bladder syndrome (OAB) is a prevalent medical problem with a significant impact on the quality of life of the affected individuals. Pharmacotherapy is considered the main treatment method, although it is discontinued in a significant proportion of patients due to inefficacy or associated side effects. If pharmacotherapy fails, patients can undergo peripheral neuromodulation of the somatic nerves of the lower limb or sacral neuromodulation; however, neither of these represents an ideal therapeutic tool. The Peroneal electric Transcutaneous NeuroModulation (Peroneal eTNM®), based on the selective stimulation of the peroneal nerve, is the new fully noninvasive neuromodulation method intended to treat OAB. The URIS® neuromodulation system, engineered to provide Peroneal eTNM®, consists of the URIS® device, URIS® active electrodes, and the biofeedback foot sensor (BFS). The unique design of the URIS® device and URIS® active electrodes allows for the use of a low voltage and current during neuromodulation, which significantly reduces the unpleasant sensations. The BFS allows for precise localization of the active electrodes and for continuous adjustment of the voltage and frequency to achieve the optimal therapeutic effect. The URIS® system adopts several principles of telemedicine, which makes it compatible with the US Food and Drug Administration (FDA) and European Union (EU) regulations for home-based use. This article describes both the Peroneal eTNM® method and the URIS® neuromodulation system, including its technical specifications and data from laboratory testing. Preclinical and early clinical data demonstrate the feasibility of this new method for noninvasive OAB treatment and possible implications for clinical practice.

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Shifting the treatment paradigm in idiopathic overactive bladder

Cited by 4 publications

References 63 publications

Delivering patient‐centered care through shared decision making in overactive bladder

Delivering patient‐centered care through shared decision making in overactive bladder

Efficacy and safety of tibial nerve stimulation using a wearable device for overactive bladder

Peroneal Electric Transcutaneous NeuroModulation (eTNM®): A Novel Method for the Treatment of the Overactive Bladder

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