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Open Access Research article

The patient perspective on overactive bladder: a mixed-methods needs assessment

Frank A Filipetto12, Kimberly G Fulda12, Amy E Holthusen3*, Thomas M McKeithen4 and Pam McFadden5

Author Affiliations

1 Department of Family Medicine, University of North Texas Health Science Center, 855 Montgomery Street, Fort Worth 76107, USA

2 Texas Prevention Institute, University of North Texas Health Science Center, (3500 Camp Bowie Blvd.), Fort Worth 76107, USA

3 Interstate Postgraduate Medical Association, P.O. Box 5474 Madison 53705, USA

4 Healthcare Performance Consulting, Inc. (2321 Stockton Drive), Fleming Island 32003, USA

5 Department of Professional and Continuing Education, University of North Texas Health Science, Center (3500 Camp Bowie Blvd.), Fort Worth (76107), USA

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BMC Family Practice 2014, 15:96  doi:10.1186/1471-2296-15-96

Published: 14 May 2014

Abstract

Background

While overactive bladder is often managed in the primary care setting, a number of barriers including embarrassment, poor communication, and low patient adherence contribute to the under-treatment of patients with burdensome urinary symptoms. In order to address these challenges, it is crucial to have a fundamental understanding of patient perspectives toward OAB and urinary symptoms. To meet this aim, researchers designed and conducted a study to identify patients’ knowledge, experiences and attitudes, barriers to treatment adherence, and desires and tendencies regarding patient/clinician communications.

Methods

A mixed-methods qualitative/quantitative needs assessment of patients with overactive bladder and/or urinary symptoms. Researchers conducted in-depth qualitative interviews via telephone with 40 patients. Interview results informed the design and dissemination of a quantitative survey, which was completed by 200 self-selected respondents who had previously identified themselves as having overactive bladder or bladder problems. Statistical and qualitative analysis of results were conducted.

Results

Among survey respondents, an average of 3.5 years elapsed between symptom onset and seeking diagnosis by a physician. In the long term most patients do not experience improvement in symptoms. Medication non-adherence is common and is related to therapy effectiveness and adverse effects. Patients clearly indicate that communication and patient/physician relationships are important to them and they would prefer the clinician initiate the conversation on overactive bladder. Patient experiences, perspectives, and attitudes toward their bladder symptoms differ in many ways from clinicians’ assumptions.

Conclusions

The significant time gap between symptom onset and diagnosis indicates ongoing need for screening and diagnosis of overactive bladder. Contrary to guideline recommendations, urinalysis and physical examination are not widely used in clinical practice. Many patients experience no improvement in symptoms over time. Patients indicate that clinician/patient relationships and communication regarding their condition are important.

Keywords:
Overactive bladder; OAB; Needs assessment; Patient survey; Patient perspective