Baseline Characteristics of Patients With Overactive Bladder Receiving Navigated or Routine Care Identified From a US National Retrospective Database Study

Enemchukwu E1, Miles-Thomas J2, Abraham N3, Luo L4, Newman D5, Nelson M4, Syan R6

Research Type

Clinical

Abstract Category

Overactive Bladder

Abstract 373
Open Discussion ePosters
Scientific Open Discussion Session 23
Friday 9th September 2022
15:20 - 15:25 (ePoster Station 2)
Exhibition Hall
Overactive Bladder Retrospective Study Incontinence
1. Stanford Multidisciplinary Pelvic Health Center, Stanford Health Care, 2. Eastern Virginia Medical School, The Devine-Jordan Center for Reconstructive Surgery and Pelvic Health, 3. Montefiore Medical Center, 4. AbbVie, 5. Perelman School of Medicine, University of Pennsylvania, Penn Center for Continence and Pelvic Health, Division of Urology, 6. University of Miami, Miller School of Medicine
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Abstract

Hypothesis / aims of study
Overactive bladder (OAB) is a highly prevalent condition that is undertreated, although some effective interventions are available. Previous research has demonstrated that navigation of care can help guide patients through the OAB clinical pathway, leading to initiation and continuation of third-line treatment options. The present study evaluated the real-world demographics of OAB patients receiving navigated care compared with those who did not. The objective was to describe the real-world demographic and geographic characteristics of OAB patients identified in a large electronic medical records database representing over 90 community-based urology practices stratified by those who received navigated care and those who did not.
Study design, materials and methods
A random set of patients with OAB were retrospectively identified using the ninth and tenth revisions of the International Classification of Diseases, Clinical Modification and procedure codes from the Precision Point Specialty Analytics Portal for OAB database. This database contains the electronic medical record data for community-based urology practices in the US that provide care to over 2.4 million OAB patients. Eligible patients were ≥18 years of age, newly diagnosed and treated for OAB between January 1, 2015, and December 31, 2019, and had ≥2 OAB visits at least 30 days apart. Pregnancy, interstitial cystitis or cystitis after radiation treatment, chronic urinary retention, and neurogenic lower urinary tract dysfunction were exclusion criteria. Treatment navigation was identified by assessing whether the practice offered navigated care, whether the patients had been assigned to a navigator list, and if the navigator-initiated care management through notes or action items in the patient’s chart.
Results
A total of 9000 patients were randomly selected from the 190,697 patients who met all study inclusion criteria. Median age at diagnosis was 67 years (IQR 55-75); Overall, 60% (n=5392) of patients were female and 70% (n=6296) were White (Table 1). A greater percentage of women (17.4%) received navigated care compared with men (5.8%). 18.1% of Black patients received navigated care followed by Asian (14.2%) and White (13.0%) patients. Overall, Medicare (n=3847, 42.7%) and private insurance (n=2504, 27.8%) were the most prevalent insurance types. Within the navigated care group, 20.7% of patients on Medicaid received navigated care, 14.6% on Medicare, 11.0% on private insurance, 10.8% on self-pay insurance, and 8.3% on military insurance, indicating that a larger proportion of patients on Medicaid received navigated care compared with other insurance types. While the Atlanta Medicare region 4 had the most overall number of patients in the study (n=2693, 29.9%; Figure), only 10.5% of those patients received navigated care. In Medicare regions 3 (Philadelphia) and 5 (Chicago), 25.2% and 23.5% of the patients received navigated care, respectively, and in Medicare regions 6 (Dallas) and 10 (Seattle), 10.4% and 9.8% of the patients received navigated care, respectively.
Interpretation of results
These results suggest that a small portion of men and women with OAB receive navigated care. Navigated patients were more often women of a variety of races on Medicaid or Medicare.
Concluding message
There is potential to increase the implementation of navigator-based care for OAB symptom control across all studied demographics.
Figure 1
Figure 2
Disclosures
Funding Support: Allergan (prior to its acquisition by AbbVie) Clinical Trial No Subjects Human
20/11/2024 07:48:55