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10:47 - 10:51
ICCS S4-7
(SO)
PERSISTENCE AND PATTERNS OF ANTICHOLINERGIC THERAPY IN PEDIATRIC
Stephane BOLDUC, Anne-Sophie BLAIS, Michelle BERGERON and Geneviève NADEAU
CHU de Québec-Université Laval, Surgery, Quebec, CANADA
PURPOSE
Overactive bladder symptoms (OAB) are complex and generally require long-term therapy. Despite the impact of these
symptoms on patients’ well-being, persistence rates of antimuscarinics have been shown to be low in adults, but have
never been studied in children. Better understanding of treatment patterns of children on antimuscarinics could help
improve the quality of drug management and outcomes. Our objective was to evaluate treatment patterns of patients
<18years of age on antimuscarinic therapy over a 4-year period.
MATERIAL AND METHODS
Pediatric patients receiving a first antimuscarinic prescription between April 2007 and March 2008 were identified using
IMS Brogan’s Public and Private Drug Plans Database and were analyzed retrospectively. Patients were followed for 4
years to assess: prescribed drugs, lines of treatment and the average duration on each treatment.
RESULTS
Data were available for 374 patients. The most prescribed drugs as first line were Oxybutynin (326) and Tolterodine
(33). Patients refilled their index prescriptions for an average of 429 days. Solifenacin had the highest mean duration
(765 days) followed by Oxybutynin and Tolterodine. During the 4-year follow-up, 324 patients (86,6%) only had one
line of therapy. At the end of follow-up, 44 patients (11,8%) still persisted on therapy.
CONCLUSIONS
Discontinuation rate of antimuscarinic therapy in children (88% at 4 years) seems comparable to reported rates in adult
OAB (65-89% at 12 months). However, children seem to persist on medication for a longer duration before adherence
start declining. The low rate of persistence highlights the importance of identifying alternatives to antimuscarinics.