Impact of Transdermal Oxybutynin on Work Productivity in Patients with Overactive Bladder
Background: Overactive bladder syndrome (OAB) is a common condition affecting a significant number of working adults, resulting in increased healthcare utilization, reduced quality of life and decreased work productivity. The MATRIX study was a large, prospective, community-based, observational US study aimed at evaluating the impact of oxybutynin transdermal system (OXY-TDS). In this paper, we report on productivity findings among working adults in MATRIX.
Methods: This study enrolled 2878 adults (aged ≥18 years) with symptoms of OAB from 327 practice sites throughout the US. All subjects received OXY-TDS (3.9 mg/day up to 6 months). Baseline versus end-of-study productivity was measured using the Work Productivity Questionnaire (WPQ). The WPQ includes a subset of questions from the Work Limitations Questionnaire (WLQ) and consists of four scales: (i) physical; (ii) time management; (iii) mental; and (iv) output demands. Overall productivity was measured by the work productivity index score (WPQ Index; a summary score based on scales) and work productivity loss score (WPLS; a measure of reduced output compared with healthy workers). Psychometric performance of the WPQ instrument is also reported, since this study represents the first use of the tool.
Results: Of the participants, 52% were of working age (18–65 years) and 38.6% were employed. A total of 1112 working adults participated in MATRIX and were included in this analysis. They had a mean age of 52.4 years; 92.2% were female and 80.9% were Caucasian. Subjects who reported that they were most affected by OAB were also most impaired at work. After OXY-TDS treatment, participants experienced significant improvements in mean scores for all four WPQ scales (p ≤0.0002) and the mean WPQ Index decreased from 8.2 to 5.5 (p < 0.0001). In addition, the WPLS decreased from 7.7% to 5.2% (p < 0.0001), indicating improvement in work function with OXY-TDS treatment.
Conclusion: OAB contributes to decreased work productivity due to job interruptions as well as fatigue. OXY-TDS may result in productivity improvement when patients receive 3.9 mg/day via twice weekly patch application for up to 6 months.
KeywordsOxybutynin Tolterodine Solifenacin Last Observation Carry Forward Work Limitation Questionnaire
This study was funded by a research grant to Quintiles and Jefferson Medical College from Watson Laboratories, Inc. Jefferson Medical College has in the past, through Laura Pizzi, received honoraria and grants from Watson Laboratories, Inc. Naomi Dahl is an employee of Watson Laboratories, Inc. Peter Sand has acted as a consultant to a number of pharmaceutical companies, including Watson Laboratories, Inc. and Astellas. He has also received honoraria and grants from these companies.
The authors thank Deborah Lerner, PhD, for her guidance regarding adaptation of the Work Limitations Questionnaire for this study. Interim findings were presented in and abstract at the International Society for Pharmacoeconomics and Outcomes Research (ISPOR) European Congress (November 2005), validation findings related to the productivity instrument were presented in an abstract at the ISPOR Annual Meeting (May 2006) and portions of the final results were presented in an abstract at the International Urogynecological Association Annual Meeting (September 2006).
- 1.Milsom I, Abrams P, Cardozo L, et al. How widespread are the symptoms of an overactive bladder and how are they managed? A population-based prevalence study [published erratum appears in BJU Int 2001; 88 (7): 807]. BJU Int 2001; 87 (9): 760–6Google Scholar
- 6.Sand PK, Kelleher C, Pizzi LT, et al. Effect of treatment for overactive bladder on work productivity: results from the MATRIX study [poster]. International Urogynecological Association (IUGA) 31st Annual Meeting; 2006 Sep 6–9; AthensGoogle Scholar
- 12.Ko Y, Lin SJ, Salmon JW, et al. The impact of urinary incontinence on quality of life of the elderly. Am J Manag Care 2005; 11: S103–11Google Scholar
- 16.Kelleher CJ, Kreder KJ, Pleil AM, et al. Long-term health-related quality of life of patients receiving extended-release tolterodine for overactive bladder. Am J Manag Care 2002; 8: S616–30Google Scholar
- 19.Davila GW, Daugherty CA, Sanders SW. A short-term, multicenter, randomized double-blind dose titration study of the efficacy and anticholinergic side effects of transdermal compared to immediate release oral oxybutynin treatment of patients with urge urinary incontinence. Transdermal Oxybutynin Study Group. J Urol 2001; 166: 140–5Google Scholar
- 22.Talati AR, Pizzi LT, Dahl N, et al. Validation of the work productivity questionnaire: results of the MATRIX study. ISPOR 11th Annual International Meeting; 2006 May 20–24; Philadelphia (PA)Google Scholar
- 24.Kelleher CJ, Reese PR, Pleil AM, et al. Health-related quality of life of patients receiving extended-release tolterodine for overactive bladder. Am J Manag Care 2002; 8: S608–15Google Scholar
- 26.Talati AR, Pizzi LT, Dahl N, et al. Work productivity in patients with overactive bladder: results from the MATRIX study. ISPOR 11th Annual International Meeting; 2006 May 20–24; Philadelphia (PA)Google Scholar