Skip to main content

Outcome Measures and Patient Expectations for Overactive Bladder

  • Chapter
  • First Online:
  • 520 Accesses

Abstract

In order to develop an appropriate treatment strategy, an assessment of patient bother, impact on quality of life, and goals for care are of utmost importance. We herein provide a review of the available medical literature on outcome measures for OAB commonly used by providers for diagnosis and symptom tracking. Specifically, we discuss the use of bladder diaries, patient-reported outcomes (PROs) such as disease-specific and generic validated questionnaires, urodynamic evaluation, patient pre-set expectations, and cost of care. While many outcome measures exist, it is challenging to select one that is expeditious, easy to understand, complete, and provides a thorough assessment of the patient satisfaction or outcome. Providers may consider utilizing shared decision-making to set realistic expectations and choose a practical outcome measure specific to one’s clinical practice to optimize patient care and satisfaction.

This is a preview of subscription content, log in via an institution.

Buying options

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD   129.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD   109.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

References

  1. Coyne KS, Payne C, Bhattacharyya SK, Revicki DA, Thompson C, Corey R, Hunt TL. 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(4):455–63.

    Article  Google Scholar 

  2. Artibani W. Outcomes in overactive bladder treatment: patient perception – a key to success. Eur Urol Suppl. 2007;6:17–22.

    Article  Google Scholar 

  3. Irwin DE, Milsom I, Kopp Z, Abrams P; EPIC Study Group. Symptom bother and health care–seeking behavior among individuals with overactive bladder. Eur Urol. 2008;53(5):1029–39.

    Google Scholar 

  4. Vaughan CP, Johnson TM 2nd, Ala-Lipasti MA, Cartwright R, Tammela TL, Taari K, et al. The prevalence of clinically meaningful overactive bladder: bother and quality of life results from the population-based FINNO study. Eur Urol. 2011;59(4):629–36.

    Article  Google Scholar 

  5. Coyne KS, Sexton CC, Kopp ZS, Ebel-Bitoun C, Milsom I, Chapple C. The impact of overactive bladder on mental health, work productivity and health-related quality of life in the UK and Sweden: results from EpiLUTS. BJU Int. 2011;108(9):1459–71.

    Article  Google Scholar 

  6. Milsom I, Kaplan SA, Coyne KS, Sexton CC, Kopp ZS. Effect of bothersome overactive bladder symptoms on health-related quality of life, anxiety, depression, and treatment seeking in the United States: results from EpiLUTS. Urology. 2012;80(1):90–6.

    Article  Google Scholar 

  7. Norton PA, MacDonald LD, Sedgwick PM, Stanton SL. Distress and delay associated with urinary incontinence, frequency, and urgency in women. BMJ. 1988;297(6657):1187–9.

    Article  CAS  Google Scholar 

  8. Grimby A, Milsom I, Molander U, Wiklund I, Ekelund P. The influence of urinary incontinence on the quality of life of elderly women. Age Ageing. 1993;22(2):82–9.

    Article  CAS  Google Scholar 

  9. Coyne KS, Zhou Z, Bhattacharyya SK, Thompson CL, Dhawan R, Versi E. The prevalence of nocturia and its effect on health-related quality of life and sleep in a community sample in the USA. BJU Int. 2003;92(9):948–54.

    Article  CAS  Google Scholar 

  10. Kenton K, FitzGerald MP, Brubaker L. What is a clinician to do – believe the patient or her urinary diary? J Urol. 2006;176(2):633–5.

    Article  Google Scholar 

  11. Lose G, Fantl JA, Victor A, Walter S, Wells TL, Wyman J, Mattiasson A. Outcome measures for research in adult women with symptoms of lower urinary tract dysfunction. Neurourol Urodyn. 1998;17(3):255–62.

    Article  CAS  Google Scholar 

  12. van Haarst EP, Bosch JL. The optimal duration of frequency-volume charts related to compliance and reliability. Neurourol Urodyn. 2014;33(3):296–301.

    Article  Google Scholar 

  13. Dmochowski RR, Sanders SW, Appell RA, Nitti VW, Davila GW. Bladder-health diaries: an assessment of 3-day vs 7-day entries. BJU Int. 2005;96(7):1049–54.

    Article  Google Scholar 

  14. Ku JH, Jeong IG, Lim DJ, Byun SS, Paick JS, Oh SJ. Voiding diary for the evaluation of urinary incontinence and lower urinary tract symptoms: prospective assessment of patient compliance and burden. Neurourol Urodyn. 2004;23(4):331–5.

    Article  Google Scholar 

  15. Bright E, Drake MJ, Abrams P. Urinary diaries: evidence for the development and validation of diary content, format, and duration. Neurourol Urodyn. 2011;30(3):348–52.

    Article  Google Scholar 

  16. Abrams P, Artibani W, Gajewski JB, Hussain I. Assessment of treatment outcomes in patients with overactive bladder: importance of objective and subjective measures. Urology. 2006;68(2 Suppl):17–28.

    Article  Google Scholar 

  17. Acquadro C, Berzon R, Dubois D, Leidy NK, Marquis P, Revicki D, Rothman M; PRO Harmonization Group. Incorporating the patient’s perspective into drug development and communication: an ad hoc task force report of the Patient-Reported Outcomes (PRO) harmonization group meeting at the food and drug administration, February 16, 2001. Value Health. 2003;6(5):522–31.

    Google Scholar 

  18. Willke RJ, Burke LB, Erickson P. Measuring treatment impact: a review of patient-reported outcomes and other efficacy endpoints in approved product labels. Control Clin Trials. 2004;25(6):535–52.

    Article  Google Scholar 

  19. Marschall-Kehrel D, Roberts RG, Brubaker L. Patient-reported outcomes in overactive bladder: the influence of perception of condition and expectation for treatment benefit. Urology. 2006;68(2 Suppl):29–37.

    Article  Google Scholar 

  20. Cotterill N, Goldman H, Kelleher C, Kopp Z, Tubaro A, Brubaker L. What are the best outcome measures when assessing treatments for LUTD? – achieving the most out of outcome evaluation: ICI-RS 2011. Neurourol Urodyn. 2012;31(3):400–3.

    Article  CAS  Google Scholar 

  21. Abrams P, Kelleher CJ, Kerr LA, Rogers RG. Overactive bladder significantly affects quality of life. Am J Manag Care. 2000;6(11 Suppl):S580–90.

    CAS  PubMed  Google Scholar 

  22. Wiklund I. Assessment of patient-reported outcomes in clinical trials: the example of health-related quality of life. Fundam Clin Pharmacol. 2004;18(3):351–63.

    Article  CAS  Google Scholar 

  23. Chassany O, Sagnier P, Marquis P, Fullerton S, Aaronson N; European Regulatory Issues on Quality of Life Assessment Group. Patient-reported outcomes: the example of health-related quality of life – a European guidance document for the improved integration of health-related quality of life assessment in the drug regulatory process. Drug Inf J. 2002;36:209–38.

    Google Scholar 

  24. Bartoli S, Aguzzi G, Tarricone R. Impact on quality of life of urinary incontinence and overactive bladder: a systematic literature review. Urology. 2010;75(3):491–500.

    Article  Google Scholar 

  25. Kelleher CJ, Cardozo LD, Khullar V, Salvatore S. A new questionnaire to assess the quality of life of urinary incontinent women. Br J Obstet Gynaecol. 1997;104(12):1374–9.

    Article  CAS  Google Scholar 

  26. Coyne K, Revicki D, Hunt T, Corey R, Stewart W, Bentkover J, et al. Psychometric validation of an overactive bladder symptom and health-related quality of life questionnaire: the OAB-q. Qual Life Res. 2002;11(6):563–74.

    Article  CAS  Google Scholar 

  27. McKown S, Abraham L, Coyne K, Gawlicki M, Piault E, Vats V. Linguistic validation of the N-QOL (ICIQ), OAB-q (ICIQ), PPBC, OAB-S and ICIQ-MLUTSsex questionnaires in 16 languages. Int J Clin Pract. 2010;64(12):1643–52.

    Article  CAS  Google Scholar 

  28. Coyne KS, Matza LS, Thompson CL, Kopp ZS, Khullar V. Determining the importance of change in the overactive bladder questionnaire. J Urol. 2006;176(2):627–32.

    Article  Google Scholar 

  29. Coyne KS, Thompson CL, Lai JS, Sexton CC. An overactive bladder symptom and health-related quality of life short-form: validation of the OAB-q SF. Neurourol Urodyn. 2015;34(3):255–63.

    Article  Google Scholar 

  30. Coyne KS, Matza LS, Kopp Z, Abrams P. The validation of the patient perception of bladder condition (PPBC): a single-item global measure for patients with overactive bladder. Eur Urol. 2006;49(6):1079–86.

    Article  Google Scholar 

  31. Reilly K, McKown S, Gawlicki M, Coyne KS. Linguistic validation of the patient perception of bladder condition questionnaire (PPBC) in 10 languages (abstract PUK25). Value Health. 2006;9(6):A392.

    Google Scholar 

  32. Matza LS, Thompson CL, Krasnow J, Brewster-Jordan J, Zyczynski T, Coyne KS. Test-retest reliability of four questionnaires for patients with overactive bladder: the overactive bladder questionnaire (OAB-q), patient perception of bladder condition (PPBC), urgency questionnaire (UQ), and the primary OAB symptom questionnaire (POSQ). Neurourol Urodyn. 2005;24(3):215–25.

    Article  Google Scholar 

  33. Coyne KS, Sexton CC, Thompson C, Bavendam T, Brubaker L. Development and psychometric evaluation of the urgency questionnaire for evaluating severity and health-related quality of life impact of urinary urgency in overactive bladder. Int Urogynecol J. 2015;26(3):373–82.

    Article  Google Scholar 

  34. Moraes RP, Silva JLD, Calado AA, Cavalcanti GA. Validation of the urgency questionnaire in Portuguese: a new instrument to assess overactive bladder syndrome. Int Braz J Urol. 2018;44(2):338–47.

    Article  Google Scholar 

  35. Jackson S, Donovan J, Brookes S, Eckford S, Swithinbank L, Abrams P. The Bristol female lower urinary tract symptoms questionnaire: development and psychometric testing. Br J Urol. 1996;77(6):805–12.

    Article  CAS  Google Scholar 

  36. Donovan JL, Abrams P, Peters TJ, Kay HE, Reynard J, Chapple C, et al. The ICS-‘BPH’ study: the psychometric validity and reliability of the ICS male questionnaire. Br J Urol. 1996;77(4):554–62.

    Article  CAS  Google Scholar 

  37. Avery K, Donovan J, Peters TJ, Shaw C, Gotoh M, Abrams P. ICIQ: a brief and robust measure for evaluating the symptoms and impact of urinary incontinence. Neurourol Urodyn. 2004;23(4):322–30.

    Article  Google Scholar 

  38. Nyström E, Sjöström M, Stenlund H, Samuelsson E. ICIQ symptom and quality of life instruments measure clinically relevant improvements in women with stress urinary incontinence. Neurourol Urodyn. 2015;34(8):747–51.

    Article  Google Scholar 

  39. Shumaker SA, Wyman JF, Uebersax JS, McClish D, Fantl JA. Health-related quality of life measures for women with urinary incontinence: the Incontinence Impact Questionnaire and the Urogenital Distress Inventory. Continence Program in Women (CPW) Research Group. Qual Life Res. 1994;3(5):291–306.

    Article  CAS  Google Scholar 

  40. Uebersax JS, Wyman JF, Shumaker SA, McClish DK, Fantl JA. Short forms to assess life quality and symptom distress for urinary incontinence in women: the Incontinence Impact Questionnaire and the Urogenital Distress Inventory. Continence Program for Women Research Group. Neurourol Urodyn. 1995;14(2):131–9.

    Article  CAS  Google Scholar 

  41. Dyer KY, Xu Y, Brubaker L, Nygaard I, Markland A, Rahn D, et al.; Urinary Incontinence Treatment Network (UITN). Minimum important difference for validated instruments in women with urge incontinence. Neurourol Urodyn. 2011;30(7):1319–24.

    Google Scholar 

  42. Wagner TH, Patrick DL, Bavendam TG, Martin ML, Buesching DP. Quality of life of persons with urinary incontinence: development of a new measure. Urology. 1996;47(1):67–72.

    Article  CAS  Google Scholar 

  43. Patrick DL, Khalaf KM, Dmochowski R, Kowalski JW, Globe DR. Psychometric performance of the incontinence quality-of-life questionnaire among patients with overactive bladder and urinary incontinence. Clin Ther. 2013;35(6):836–45.

    Article  Google Scholar 

  44. Piault E, Evans CJ, Espindle D, Kopp Z, Brubaker L, Abrams P. Development and validation of the overactive bladder satisfaction (OAB-S) questionnaire. Neurourol Urodyn. 2008;27(3):179–90.

    Article  Google Scholar 

  45. Pleil AM, Coyne KS, Reese PR, Jumadilova Z, Rovner ES, Kelleher CJ. The validation of patient-rated global assessments of treatment benefit, satisfaction, and willingness to continue – the BSW. Value Health. 2005;8(Suppl 1):S25–34.

    Article  Google Scholar 

  46. Colman S, Chapple C, Nitti V, Haag-Molkenteller C, Hastedt C, Massow U. Validation of treatment benefit scale for assessing subjective outcomes in treatment of overactive bladder. Urology. 2008;72(4):803–7.

    Article  CAS  Google Scholar 

  47. Coyne KS, Margolis MK, Vats V, Nitti VW. Psychometric evaluation of brief patient-reported outcome measures of overactive bladder: the ICIQ-SF, SAC, SATS, SATT, and TBS. Health Outcomes Res Med. 2011;2(2):e61–9.

    Article  Google Scholar 

  48. Brubaker L, Khullar V, Piault E, Evans CJ, Bavendam T, Beach J, et al. Goal attainment scaling in patients with lower urinary tract symptoms: development and pilot testing of the Self-Assessment Goal Achievement (SAGA) questionnaire. Int Urogynecol J. 2011;22(8):937–46.

    Article  Google Scholar 

  49. Brubaker L, Piault EC, Tully SE, Evans CJ, Bavendam T, Beach J, et al. Validation study of the Self-Assessment Goal Achievement (SAGA) questionnaire for lower urinary tract symptoms. Int J Clin Pract. 2013;67(4):342–50.

    Article  CAS  Google Scholar 

  50. Piault E, Doshi S, Brandt BA, Angün Ç, Evans CJ, Bergqvist A, Trocio J. Linguistic validation of translation of the Self-Assessment Goal Achievement (SAGA) questionnaire from English. Health Qual Life Outcomes. 2012;10:40.

    Article  Google Scholar 

  51. Ware JE, Sherbourne CD. The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care. 1992;30(6):473–83.

    Article  Google Scholar 

  52. EuroQol Group. EuroQol – a new facility for the measurement of health-related quality of life. Health Policy. 1990;16(3):199–208.

    Article  Google Scholar 

  53. Walters SJ, Brazier JE. Comparison of the minimally important difference for two health state utility measures: EQ-5D and SF-6D. Qual Life Res. 2005;14(6):1523–32.

    Article  Google Scholar 

  54. Reese PR, Pleil AM, Okano GJ, Kelleher CJ. Multinational study of reliability and validity of the King’s health questionnaire in patients with overactive bladder. Qual Life Res. 2003;12(4):427–42.

    Article  Google Scholar 

  55. Abrams P, Avery K, Gardener N, Donovan J; ICIQ Advisory Board. The international consultation on incontinence modular questionnaire: www.iciq.net. J Urol. 2006;175(3 Pt 1):1063–6.

  56. Haywood KL, Garratt AM, Lall R, Smith JF, Lamb SE. EuroQol EQ-5D and condition-specific measures of health outcome in women with urinary incontinence: reliability, validity and responsiveness. Qual Life Res. 2008;17(3):475–83.

    Article  Google Scholar 

  57. McHorney CA, Ware JE Jr, Lu JF, Sherbourne CD. The MOS 36-item short-form health survey (SF-36): III. Tests of data quality, scaling assumptions, and reliability across diverse patient groups. Med Care. 1994;32(1):40–66.

    Article  CAS  Google Scholar 

  58. McHorney CA, Ware JE Jr, Raczek AE. The MOS 36-item short-form health survey (SF-36): II. Psychometric and clinical tests of validity in measuring physical and mental health constructs. Med Care. 1993;31(3):247–63.

    Article  CAS  Google Scholar 

  59. The International Consortium for Health Outcomes Measurement (ICHOM). http://www.ichom.org/. Accessed 5 Jan 2018.

  60. Foust-Wright C, Wissig S, Stowell C, Olson E, Anderson A, Anger J, et al. Development of a core set of outcome measures for OAB treatment. Int Urogynecol J. 2017;28(12):1785–93.

    Article  Google Scholar 

  61. Guyatt GH, Oxman AD, Kunz R, Atkins D, Brozek J, Vist G, et al. GRADE guidelines: 2. Framing the question and deciding on important outcomes. J Clin Epidemiol. 2011;64(4):395–400.

    Article  Google Scholar 

  62. Reeve BB, Wyrwich KW, Wu AW, Velikova G, Terwee CB, Snyder CF, et al. ISOQOL recommends minimum standards for patient-reported outcome measures used in patient-centered outcomes and comparative effectiveness research. Qual Life Res. 2013;22(8):1889–905.

    Article  Google Scholar 

  63. Frankel SJ, Donovan JL, Peters TI, Abrams P, Dabhoiwala NF, Osawa D, Lin AT. Sexual dysfunction in men with lower urinary tract symptoms. J Clin Epidemiol. 1998;51(8):677–85.

    Article  CAS  Google Scholar 

  64. Aitchison M, Carter R, Paterson P, Ferrie B. Is the treatment of urgency incontinence a placebo response? Results of a five-year follow-up. Br J Urol. 1989;64(5):478–80.

    Article  CAS  Google Scholar 

  65. Digesu GA, Khullar V, Cardozo L, Salvatore S. Overactive bladder symptoms: do we need urodynamics? Neurourol Urodyn. 2003;22(3):105–8.

    Article  Google Scholar 

  66. Irwin DE, Milsom I, Hunskaar S, Reilly K, Kopp Z, Herschorn S, et al. Population-based survey of urinary incontinence, overactive bladder, and other lower urinary tract symptoms in five countries: results of the EPIC study. Eur Urol. 2006;50(6):1306–14; discussion 1314–5.

    Article  Google Scholar 

  67. Hu TW, Wagner TH, Bentkover JD, LeBlanc K, Piancentini A, Stewart WF, et al. Estimated economic costs of overactive bladder in the United States. Urology. 2003;61(6):1123–8.

    Article  Google Scholar 

  68. Balkrishnan R, Bhosle MJ, Camacho FT, Anderson RT. Predictors of medication adherence and associated health care costs in an older population with overactive bladder syndrome: a longitudinal cohort study. J Urol. 2006;175(3 Pt 1):1067–71; discussion 1071–2. Erratum in J Urol. 2006;175(5):1967.

    Article  Google Scholar 

  69. Kalsi V, Popat RB, Apostolidis A, Kavia R, Odeyemi IA, Dakin HA, et al. Cost-consequence analysis evaluating the use of botulinum neurotoxin-A in patients with detrusor overactivity based on clinical outcomes observed at a single UK centre. Eur Urol. 2006;49:519–27.

    Article  CAS  Google Scholar 

  70. Appleby J, Devlin N, Parkin D. NICE’s cost effectiveness threshold. BMJ. 2007;335(7616):358–9.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Gary E. Lemack .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2019 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Lemack, G.E., Malik, R.D. (2019). Outcome Measures and Patient Expectations for Overactive Bladder. In: Cox, L., Rovner, E. (eds) Contemporary Pharmacotherapy of Overactive Bladder. Springer, Cham. https://doi.org/10.1007/978-3-319-97265-7_4

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-97265-7_4

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-97264-0

  • Online ISBN: 978-3-319-97265-7

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics