Abstract
Introduction and hypothesis
The goal was to identify correlates of patient satisfaction with drug and behavioral treatments for urge-predominant incontinence, which may help tailor treatments to improve satisfaction.
Methods
Planned secondary analysis of a multi-center, clinical trial randomizing 307 women to 10 weeks of tolterodine alone or combined with behavioral training. Satisfaction was measured using the Patient Satisfaction Question (PSQ). Potential correlates included baseline demographics, incontinence characteristics and prior treatments, history and physical parameters, expectations of treatment success, and outcome variables including the Global Perception of Improvement (GPI) and Urogenital Distress Inventory (UDI).
Results
After multivariable analysis, every 10-point increase in UDI change score increased odds of satisfaction by 11% (OR 1.11; 1.04–1.19). Odds of satisfaction increased among women reporting “much better” on the GPI (OR 13.8; 4.94–38.60).
Conclusions
Treatment satisfaction for women with urge-predominant incontinence was associated with patient-related outcomes reflecting impression of improvement and bother from incontinence-related symptoms.
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Acknowledgments
This study was supported by grants from the National Institute of Diabetes and Digestive and Kidney Diseases (U01 DK 58225, U01 DK58234, U01 DK58229, U01 DK58231, U01 DK60397, U01 DK60401, U01 DK60395, U01 DK60393, U01 DK60380, U01 DK60379). Additional support, including provision of study drugs and funding, was contributed by Pfizer.
Conflicts of interest
Patricia S. Goode has received research funding from Pfizer. Kathryn L. Burgio is a member of the Advisory Board of Astellas and has received research funding from Pfizer and consultant’s fees from Pfizer and Johnson & Johnson. Stephen R. Kraus is a course director and faculty member at Laborie and has received speaker’s fee from Novartis and consultant and speaker’s fees and research funding from Pfizer. Kimberly Kenton has received research funding from Pfizer and consultant’s fee from Intuitive Surgical. Holly E. Richter has received research funding from University of California/Pfizer and Astellas, consultant’s fees from Pfizer, Astellas, Xanodyne, IDEO, and Uromedica, and an educational grant from Warner Chilcott. Heather J. Litman declares that she has no conflicts of interest.
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ClinicalTrials.gov NCT00090584
Appendix
Appendix
Urinary Incontinence Treatment Network
Steering committee
William Steers, MD, Chair (University of Virginia Charlottesville, VA); Ananias Diokno, MD, Veronica Mallett, MD, Salil Khandwala, MD (William Beaumont Hospital, Royal Oak, MI, and Oakwood Hospital, Dearborn MI); Linda Brubaker, MD, MaryPat FitzGerald, MD (Loyola University Medical Center, Maywood, IL); Holly E. Richter, Ph.D., MD, L. Keith Lloyd, MD (University of Alabama, Birmingham, AL); Michael Albo, MD, Charles Nager, MD (University of California, San Diego, CA); Toby C. Chai, MD, Harry W. Johnson, MD (University of Maryland, Baltimore, MD); Halina M. Zyczynski, MD, Wendy Leng, MD (University of Pittsburgh, Pittsburgh, PA); Philippe Zimmern, MD, Gary Lemack, MD (University of Texas Southwestern, Dallas, TX); Stephen Kraus, MD, Thomas Rozanski, MD (University of Texas Health Sciences Center, San Antonio, TX); Peggy Norton, MD, Lindsey Kerr, MD (University of Utah, Salt Lake City, UT); Sharon Tennstedt, Ph.D., Anne Stoddard, ScD (New England Research Institutes, Watertown, MA); Debuene Chang, MD, John W. Kusek, Ph.D., Leroy M. Nyberg, MD, Ph.D. (National Institute of Diabetes & Digestive & Kidney Diseases); Anne M. Weber, MD (National Institute of Child Health and Human Development).
Co-investigators
Diane Borello-France, PT, Ph.D.; Kathryn L. Burgio, Ph.D.; Seine Chiang, MD; Ash Dabbous, MD; Chiara Ghetti, MD; Patricia S. Goode, MD; Lee N. Hammontree, MD; Kimberly Kenton, MD; Jerry Lowder, MD, Karl Luber, MD; Emily Lukacz, MD; Alayne Markland, DO, MSc; Shawn Menefee, MD; Pamela Moalli, MD; Kenneth Peters, MD; Joseph Schaffer, MD; Amanda Simsiman, MD; Larry Sirls, MD; Robert Starr, MD; R. Edward Varner, MD.
Study coordinators
Rosemary Bradt, RNC; Laura Burr, RN; Karen Debes, RN; Tamara Dickinson, RN; Rosanna Dinh, RN, CCRC; Judy Gruss, RN; Alice Howell, RN, BSN, CCRC; Kathy Jesse, RN; D. Lynn Kalinoski, Ph.D.; Kristen Mangus; Karen Mislanovich, RN; Judy Murray, CCRC; Shelly O’Meara, RN; Janese Parent, RN; Norma Pope, RN; Caren Prather, RN; Sylvia Sluder, CCRP; Mary Tulke, RN; Robin Willingham, RN, BSN; Gisselle Zazueta-Damian.
Interventionists
Dorothy Atkins, CRNP, MS; Jan Baker, APRN; Karen Debes, RN; Kathy Jesse, RN; Ryanne R. Johnson, BSN, RNC, WHNP; Kathryn Koches, MSN, WHNP, R. Jeannine McCormick, RN, MSN, CRNP; Karen Mislanovich, RN; Christy Moore, RN, BSN; Elva Kelly Moore, RN; Amy Mutch, CRNP; Betsy Nielsen-Omeis, RN, BSN; Lisa Radebaugh, MScN, CRNP; Patsy Riley, RN; Karen VandeVegt, PT.
Biostatistical Coordinating Center
Kimberly J. Dandreo, MSc; Corinne J. Leifer, BA; Heather Litman, Ph.D., Susan M. McDermott, MPH, GNP; Anne Stoddard, ScD (Co-PI); Sharon Tennstedt, Ph.D. (PI); Liane Tinsley, BA: Yan Xu, MS.
Data Safety and Monitoring Board
Elizabeth A. Gormley, MD (Chair), Dartmouth-Hitchcock Medical Center, Lebanon, NH; Paul Abrams, MD, Bristol Urological Institute, Bristol, UK; Diedre Bland, MD, Blue Ridge Medical Associates, Winston Salem, NC; J. Quentin Clemens, MD, Northwestern University Medical School, Chicago, IL; John Connett, Ph.D., University of Minnesota, Minneapolis, MN; William Henderson, Ph.D., University of Colorado, Aurora, CO; Dee Fenner, MD, University of Michigan, Ann Arbor, MI; Sheryl Kelsey, Ph.D., University of Pittsburgh, Pittsburgh, PA; Deborah Myers, MD, Brown University School of Medicine, Providence, RI; Jacek Mostwin, MD, Johns Hopkins Hospital, Baltimore, MD; Bassem Wadie, MBBCh, MSc, MD, Mansoura Urology and Nephrology Center, Mansoura, Egypt.
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Goode, P.S., Burgio, K.L., Kraus, S.R. et al. Correlates and predictors of patient satisfaction with drug therapy and combined drug therapy and behavioral training for urgency urinary incontinence in women. Int Urogynecol J 22, 327–334 (2011). https://doi.org/10.1007/s00192-010-1287-x
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DOI: https://doi.org/10.1007/s00192-010-1287-x