, Volume 27, Issue 4, pp 329–339 | Cite as

Impact of Transdermal Oxybutynin on Work Productivity in Patients with Overactive Bladder

Results from the MATRIX Study
  • Laura T. Pizzi
  • Amy Talati
  • Eric Gemmen
  • Naomi V. Dahl
  • Thomas J. Bunz
  • Peter K. Sand
Original Research Article


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.


Oxybutynin Tolterodine Solifenacin Last Observation Carry Forward Work Limitation Questionnaire 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



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. 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
  2. 2.
    Stewart WF, Van Rooyen JB, Cundiff GW, et al. Prevalence and burden of overactive bladder in the United States. World J Urol 2003; 20: 327–36PubMedGoogle Scholar
  3. 3.
    Abrams P, Artibani W, Cardozo L, et al. Reviewing the ICS 2002 terminology report: the ongoing debate [letter]. Neurourol Urodyn 2006; 25 (3): 293CrossRefGoogle Scholar
  4. 4.
    Hu TW, Wagner TH. Health-related consequences of overactive bladder: an economic perspective. BJU Int 2005; 96 (Suppl. 1): 43–5PubMedCrossRefGoogle Scholar
  5. 5.
    Wu EQ, Birnbaum H, Marynchenko M, et al. Employees with overactive bladder: work loss burden. J Occup Environ Med 2005; 47: 439–46PubMedCrossRefGoogle Scholar
  6. 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
  7. 7.
    Milsom I, Irwin DE. A cross-sectional, population-based, multinational study of the prevalence of overactive bladder and lower urinary tract symptoms: results from the EPIC study. European Urology 2007; 6 (1): 4–9CrossRefGoogle Scholar
  8. 8.
    Irwin DE, Milsom I, Kopp A, et al. Impact of overactive bladder on symptoms of employment, social interactions and emotional well-being in six European countries. BJU Int 2005; 97: 96–100CrossRefGoogle Scholar
  9. 9.
    Hu TW, Wagner TH, Bentkover JD, et al. Estimated economic costs of overactive bladder in the United States. Urology 2003; 61: 1123–8PubMedCrossRefGoogle Scholar
  10. 10.
    Grimby A, Milsom I, Molander U, et al. The influence of urinary incontinence on the quality of life of elderly women. Age Ageing 1993; 22: 82–9PubMedCrossRefGoogle Scholar
  11. 11.
    Coyne KS, Payne C, Bhattacharyya SK, et al. The impact of urinary urgency and frequency on health-related quality of life in overactive bladder: results from a national community survey. Value Health 2004; 7: 455–63PubMedCrossRefGoogle Scholar
  12. 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
  13. 13.
    Sand PK, Goldberg RP, Dmochowski RR, et al. The impact of the overactive bladder syndrome on sexual function: a preliminary report from the multicenter assessment of transdermal therapy in overactive bladder with oxybutynin trial. Am J Obstet Gyn 2006; 195: 1730–5CrossRefGoogle Scholar
  14. 14.
    Hunskaar S, Vinsnes A. The quality of life in women with urinary incontinence as measured by the sickness impact profile. J Am Geriatr Soc 1991; 39: 378–82PubMedGoogle Scholar
  15. 15.
    Kelleher CJ, Cardozo L, Chapple CR, et al. Improved quality of life in patients with overactive bladder symptoms treated with solifenacin. BJU Int 2005; 95: 81–5PubMedCrossRefGoogle Scholar
  16. 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
  17. 17.
    Kobelt G, Kirchberger I, Malone-Lee J. Review: quality-of-life aspects of the overactive bladder and the effect of treatment with tolterodine. BJU Int 1999; 83 (6): 583–90PubMedCrossRefGoogle Scholar
  18. 18.
    Dmochowski RR, Nitti V, Staskin D, et al. Transdermal oxybutynin in the treatment of adults with overactive bladder: combined results of two randomized clinical trials. World J Urol 2005; 23: 263–70PubMedCrossRefGoogle Scholar
  19. 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
  20. 20.
    Dmochowski RR, Davila GW, Zinner NR, et al. Efficacy and safety of transdermal oxybutynin in patients with urge and mixed urinary incontinence. J Urol 2002; 168: 580–6PubMedCrossRefGoogle Scholar
  21. 21.
    Dmochowski RR, Sand PK, Zinner NR, et al. Comparative efficacy and safety of transdermal oxybutynin and oral tolterodine versus placebo in previously treated patients with urge and mixed urinary incontinence. Urology 2003; 62: 237–42PubMedCrossRefGoogle Scholar
  22. 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
  23. 23.
    Coyne KS, Matza LS, Kopp Z, et al. The validation of the patient perception of bladder condition (PPBC): a single-item global measure for patients with overactive bladder. Eur Urol 2006; 49: 1079–86PubMedCrossRefGoogle Scholar
  24. 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
  25. 25.
    Lerner D, Amick III BC, Rogers WH, et al. The work limitations questionnaire. Med Care 2001; 39: 72–85PubMedCrossRefGoogle Scholar
  26. 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
  27. 27.
    Zinner N, Noe L, Rasouliyan L, et al. Impact of solifenacin on resource utilization, work productivity, and health utility in overactive bladder patients switching from tolterodine ER. Curr Med Res Opin 2008; 24: 1583–91PubMedCrossRefGoogle Scholar
  28. 28.
    Appell RA, Sand PK. Nocturia: etiology, diagnosis, and treatment. Neurourol Urodyn 2008; 27 (1): 34–9PubMedCrossRefGoogle Scholar
  29. 29.
    Fultz NH, Fisher GG, Jenkins KR. Does urinary incontinence affect middle-aged and older women’s time use and activity patterns? Obstet Gynecol 2004; 104: 1327–34PubMedCrossRefGoogle Scholar
  30. 30.
    Kopec JA, Esdaile JM. Occupational role performance in persons with back pain. Disabil Rehabil 1998 Oct; 20 (10): 373–9PubMedCrossRefGoogle Scholar
  31. 31.
    Lofland JH, Pizzi L, Frick KD. A review of health-related workplace productivity loss instruments. Pharmacoeconomics 2004; 22 (3): 165–84PubMedCrossRefGoogle Scholar
  32. 32.
    Saha C, Jones MP. Bias in the last observation carried forward method under informative dropout. J Stat Plan Inference 2009; 2 (1): 246–55CrossRefGoogle Scholar
  33. 33.
    Lerner D, Amick BC, Lee JC, et al. Relationship of employee-reported work limitations to work productivity. Med Care 2003; 41 (5): 649–59PubMedGoogle Scholar
  34. 34.
    Sand P, Zinner N, Newman D, et al. Oxybutynin transdermal system improves the quality of life in adults with overactive bladder: a multicentre, community-based, randomized study. BJU Int 2007 Apr; 99 (4): 836–44PubMedCrossRefGoogle Scholar

Copyright information

© Adis Data Information BV 2009

Authors and Affiliations

  • Laura T. Pizzi
    • 1
  • Amy Talati
    • 2
  • Eric Gemmen
    • 3
  • Naomi V. Dahl
    • 4
  • Thomas J. Bunz
    • 1
  • Peter K. Sand
    • 5
  1. 1.Doris N. Grandon Center for Health Economics and Outcomes ResearchJefferson School of Population HealthPhiladelphiaUSA
  2. 2.Jefferson School of Population HealthPhiladelphiaUSA
  3. 3.QuintilesFalls ChurchUSA
  4. 4.Watson Laboratories, Inc.MorristownUSA
  5. 5.Evanston Continence CenterNorthwestern University, Feinberg School of MedicineEvanstonUSA

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