Fernández-Liz, Eladio;
Tristante, Pere Vivó;
Martínez, Antonio Aranzana;
Colomer, Maria Estrella Barceló;
Rebull, Josep Ossó;
Dolcet, Maria Josep López
Effectiveness of an intervention to optimise the use of mirabegron for overactive bladder: a quasi-experimental study in primary care
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Media type:
E-Article
Title:
Effectiveness of an intervention to optimise the use of mirabegron for overactive bladder: a quasi-experimental study in primary care
Contributor:
Fernández-Liz, Eladio;
Tristante, Pere Vivó;
Martínez, Antonio Aranzana;
Colomer, Maria Estrella Barceló;
Rebull, Josep Ossó;
Dolcet, Maria Josep López
imprint:
Royal College of General Practitioners, 2018
Published in:British Journal of General Practice
Language:
English
DOI:
10.3399/bjgp18x699953
ISSN:
0960-1643;
1478-5242
Origination:
Footnote:
Description:
<jats:sec><jats:title>Background</jats:title><jats:p>Overactive bladder is a composite of lower urinary tract storage symptoms. Pharmacological treatment is widely employed despite markedly modest efficacy data, adverse effects, and costs for the health system.</jats:p></jats:sec><jats:sec><jats:title>Aim</jats:title><jats:p>To determine the 12-month efficacy of an intervention delivered by GPs on mirabegron revision and, if appropriate, discontinuation of treatment.</jats:p></jats:sec><jats:sec><jats:title>Design and setting</jats:title><jats:p>Multicentre, quasi-experimental study in Barcelona (Catalonia), Spain.</jats:p></jats:sec><jats:sec><jats:title>Method</jats:title><jats:p>Two groups composed of 17 intervention and 34 control practices were formed. The follow-up period was 12 months, from 1 January to 31 December 2017. A structured intervention was designed consisting of initiatives with GPs and urology/gynaecology specialists. The primary outcome was mirabegron use at 12 months.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>Of the 1932 patients, a significant discontinuation in treatment was observed at 12 months’ follow-up in the intervention group (IG) (<jats:italic>n</jats:italic>= 433 out of 762, 56.8%), in contrast with the control one (CG) (<jats:italic>n</jats:italic>= 484 out of 1170, 41.4%) (<jats:italic>P</jats:italic><0.001). There was also a reduced incorporation of new treatments in the IG (<jats:italic>n</jats:italic>= 214 out of 762, 28.1%) compared with the CG (<jats:italic>n</jats:italic>= 595 out of 1170, 50.9%) (<jats:italic>P</jats:italic><0.001). In relation to patients with treatment at the beginning and end of the period, there was a decrease of 219 (28.7%) patients in the IG and an increase of 111 (9.5%) in the CG (<jats:italic>P</jats:italic><0.001).</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>The structured intervention showed optimisation in the use of mirabegron. When considering discontinuation it is necessary to provide clear data on the benefits and/or risks for patients and their caregivers, as such information is a precondition for shared decision making.</jats:p></jats:sec>