Study design, materials and methods
We queried Optum, a national administrative health and pharmacy claims database, between the years of 2003-2016. All patients with non-neurogenic OAB were identified using ICD9 and ICD10 diagnosis codes. Patient demographics and treatment interventions were collected, including oral medication therapies (anticholinergic and beta3 agonists), and advanced therapies (OnabotulinumtoxinA (BTX), SNS, and peripheral tibial nerve stimulation (PTNS)). Multivariate analysis was performed.
2,446,652 patients with OAB were identified. Of these, 519,279 (21.2%) were treated with oral therapies and/or advanced therapies. Of those who were treated, oral medical therapy use was high amongst all races. Regarding advanced therapies, Asians were more likely to undergo BTX than Whites, and Whites were more likely to undergo SNS and PTNS (p<0.05). On multivariate analysis, predictors of advanced OAB therapy use were age <65, occupation as a homemaker or retired, education level less than a bachelor’s degree and prior oral medical therapy use (p<0.05). Male, Asian and Hispanic patients were less likely than their counterparts to undergo an advanced OAB therapy (p<0.05) (Table 1).
Interpretation of results
In an insured population undergoing advanced OAB therapies, Asians were more likely to undergo Botox, while Whites were more likely to undergo SNS and PTNS. Younger patients (age <65), homemakers/retirees, patients with less than a bachelor’s degree and prior OAB oral medication users were more likely to undergo an advanced OAB therapy, while commercially insured males, Asians, and Hispanics were less likely to undergo advanced OAB therapies.