Title
Are we shortchanging frail older people when it comes to the pharmacological treatment of urgency urinary incontinence?Are we shortchanging frail older people when it comes to the pharmacological treatment of urgency urinary incontinence?
Author
Faculty/Department
Faculty of Medicine and Health Sciences
Research group
Translational Neurosciences (TNW)
Publication type
article
Publication
Hoboken :Wiley-blackwell,
Subject
Pharmacology. Therapy
Human medicine
Source (journal)
International journal of clinical practice. - London
Volume/pages
68(2014):9, p. 1165-1173
ISSN
1368-5031
ISI
000342805700018
Carrier
E
Target language
English (eng)
Full text (Publishers DOI)
Affiliation
University of Antwerp
Abstract
Overactive bladder and urgency incontinence are common and distressing conditions in older people, for which the first-line pharmacological treatment is a bladder antimuscarinic agent. Of these, oxybutynin is often recommended in guidelines, but is associated with a higher incidence of adverse drug effects, and in particular has been suggested to have deleterious cognitive effects. Despite this, guidelines often suggest oxybutynin as first-line treatment, and insurance based healthcare systems often require oxybutynin to be used as a first-line therapy and fail before reimbursement for the cost of newer anticholinergics is authorised. We reviewed the literature of bladder antimuscarinics in older adults, using the headings overactive bladder, urinary frequency, urgency, urge, oxybutynin, antimuscarinic, older, older people, and frail. In general, oxybutynin had a similar efficacy to other anticholinergic drugs, but a higher incidence of adverse drug events, in particular significant yet unnoticed cognitive impairment. We conclude that oxybutynin should not be used in frail older people.
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