Open Access

ARTICLE

Effects of combined behavioral intervention and tolterodine on patient-reported outcomes

Jean F. Wyman¹, Carl Klutke², Kathryn Burgio³, Zhonghong Guan⁴, Franklin Sun⁴, Sandra Berriman⁴, Tamara Bavendam⁴

1 School of Nursing, University of Minnesota, Minneapolis, Minnesota, USA
2 Department of Surgery, Washington University School of Medicine, St. Louis, Missouri, USA
3 Birmingham/Atlanta Geriatric Research, Education and Clinical Center, Department of Veterans Affairs, and University of Alabama at Birmingham, Birmingham, Alabama, USA
4 Pfizer Inc, New York, New York, USA
Address correspondence to Dr. Jean F. Wyman, School of Nursing, University of Minnesota, 5-140 Weaver-Densford Hall, 308 Harvard Street, S.E., Minneapolis, MN 55455 USA

Canadian Journal of Urology 2010, 17(4), 5283-5290.

Abstract

Objective: To assess the effects of tolterodine extended release (ER) plus behavioral intervention on urgency and other patient-reported outcomes in subjects with overactive bladder (OAB) who were previously dissatisfied with antimuscarinic treatment.
Methods: In this 16-week, multicenter, open-label study, eligible adults (aged ≥ 18 y) reported dissatisfaction with their most recent antimuscarinic OAB medication; ≥ 8 micturitions and ≥ 2 urgency episodes per 24 hours and ≥ 1 UUI episode in 5 day bladder diaries; and OAB symptoms for ≥ 3 months. Subjects received tolterodine ER plus a behavioral educational handout with verbal reinforcement of behavioral intervention content for 8 weeks. Those satisfied with treatment at week 8 continued with this therapy; those dissatisfied received tolterodine ER plus individualized behavioral intervention (pelvic floor muscle training, tailored behavioral techniques) for 8 weeks. Endpoints were changes from baseline in daytime and nocturnal micturition-related urgency episodes and frequency-urgency sum (a measure of urgency severity and frequency) reported in 5 day bladder diaries at weeks 4, 8, 12, and 16; Patient Perception of Bladder Condition (PPBC), Overactive Bladder Questionnaire (OAB-q), and Urgency Perception Scale (UPS) scores at weeks 8 and 16.
Results: Daytime and nocturnal urgency episodes and frequency-urgency sum were significantly reduced at all time points (all p < 0.0001). Significant improvements were also observed in PPBC, OAB-q Symptom Bother and Health-Related Quality of Life, and UPS scores at weeks 8 and 16 (all p < 0.0001).
Conclusions: Patients with OAB who are dissatisfied with antimuscarinic therapy may experience improved treatment outcomes by adding a self-administered behavioral intervention to their drug regimen.

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