Adherence to fesoterodine in women with overactive bladder in routine clinical practice | Actas Urológicas Españolas (English Edition)

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"apellidos" => "Martínez" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "g" "identificador" => "aff0035" ] ] ] ] "afiliaciones" => array:7 [ 0 => array:3 [ "entidad" => "Departamento de Obstetricia y Ginecología, Hospital de Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Departamento de Obstetricia y Ginecología, Corporació Sanitària Parc Taulí, Barcelona, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Departamento de Obstetricia y Ginecología, Parc de Salut Mar, Barcelona, Spain" "etiqueta" => "c" "identificador" => "aff0015" ] 3 => array:3 [ "entidad" => "Departamento de Obstetricia y Ginecología, Hospital d’Igualada, Barcelona, Spain" "etiqueta" => "d" "identificador" => "aff0020" ] 4 => array:3 [ "entidad" => "Departamento de Obstetricia y Ginecología, Hospital Viladecans, Barcelona, Spain" "etiqueta" => "e" "identificador" => "aff0025" ] 5 => array:3 [ "entidad" => "PASSIR Dreta, Institut Català de la Salut, Barcelona, Spain" "etiqueta" => "f" "identificador" => "aff0030" ] 6 => array:3 [ "entidad" => "Departamento de Obstetricia y Ginecología, Parc Sanitari Sant Joan de Déu Sant Boi, Barcelona, Spain" "etiqueta" => "g" "identificador" => "aff0035" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Adherencia a fesoterodina en mujeres con vejiga hiperactiva en la práctica clínica diaria" ] ] "textoCompleto" => "IntroductionOveractive bladder (OAB) is a common chronic condition, characterized by urinary urgency with or without urge incontinence, often with increased daytime frequency and nocturia.<a class="elsevierStyleCrossRef" href="#bib0175">1</a> In Spain, OAB prevalence rates of 5.9–11.8% have been reported for women.<a class="elsevierStyleCrossRefs" href="#bib0180">2,3</a>The symptoms associated with OAB have an adverse impact on several aspects of health-related quality of life (HRQL) in adult women of all ages,<a class="elsevierStyleCrossRef" href="#bib0190">4</a> including physical function, emotional well-being, sexual relationship, and work productivity.<a class="elsevierStyleCrossRef" href="#bib0195">5</a>Antimuscarinic agents are the pharmacological mainstay of OAB treatment.<a class="elsevierStyleCrossRef" href="#bib0200">6</a> Fesoterodine, a nonselective oral antimuscarinic agent, has shown to be effective and well tolerated.<a class="elsevierStyleCrossRef" href="#bib0205">7</a> In addition, the availability of two doses of fesoterodine provides an opportunity to establish an optimal balance between efficacy and tolerability in individual patients.<a class="elsevierStyleCrossRefs" href="#bib0210">8,9</a>For pharmacotherapy to be beneficial, good persistence and adherence are essential. Poor persistence with long-term medication in chronic diseases is common.<a class="elsevierStyleCrossRef" href="#bib0220">10</a> For overactive bladder, however, medication persistence is lower than average.<a class="elsevierStyleCrossRef" href="#bib0225">11</a> In studies that have a 6-month follow-up, antimuscarinic persistence rates of 11–30% have been reported and in studies with at least 1 year's follow-up, persistence rates range from 8% to 29%.<a class="elsevierStyleCrossRef" href="#bib0230">12</a> Persistence may vary among antimuscarinic agents.<a class="elsevierStyleCrossRefs" href="#bib0230">12,13</a> A retrospective study, carried out with medical records from Spanish primary healthcare centers, reported a cumulative probability of persisting with initial therapy significantly higher for fesoterodine than for solifenacin or tolterodine.<a class="elsevierStyleCrossRef" href="#bib0235">13</a>On the other hand, clinical practice suggests that adherence rates reported in clinical trials are much higher than in real practice.<a class="elsevierStyleCrossRef" href="#bib0230">12</a> Trial subjects receive intensive follow-up and incentives which encourage adherence, so they might not be representative of the general population treated in normal clinical practice.<a class="elsevierStyleCrossRef" href="#bib0240">14</a> Non-interventional studies, as the one we present here, may therefore provide complementary information to clinical trials.Despite well-established efficacy of fesoterodine in clinical trials, treatment non-compliance is a major obstacle to its effectiveness in clinical practice. Identification of reasons for non-compliance/discontinuation of fesoterodine medication provides an opportunity to tailor strategies aimed at improving patient compliance with treatment.We carried out a study aimed at evaluating the short-term adherence to fesoterodine treatment among women diagnosed with overactive bladder (OAB) and identifying the reasons for lack of adherence and the potential factors influencing adherence. The secondary aim was to assess the short-term patient-reported outcomes in routine clinical practice.Patients and methodsStudy design and patientsThis is an observational and retrospective study conducted at six hospitals and one primary care center of Barcelona, Spain. Eligibility criteria included adult women diagnosed with OAB according to the International Continence Society (ICS) definition, without pelvic organ prolapse (≤stage II Baden-Walker), with absence of symptoms or signs of urinary tract infection, new users of fesoterodine 4mg without dose-escalation to 8mg, and on treatment for at least three months.The study was of a non-intervention nature, and the OAB treatment prescribed was determined by the clinical judgment of the doctor responsible for the patient's management. At the time of diagnosis, as in routine clinical practice, patients completed the validated Spanish version of the International Consultation on Incontinence Questionnaire Short Form (ICIQ-UI-SF)<a class="elsevierStyleCrossRef" href="#bib0245">15</a> to assess OAB severity and the Overactive Bladder Questionnaire Short Form (OAB-qSF)<a class="elsevierStyleCrossRef" href="#bib0250">16</a> to evaluate impact of OAB on their lives. Clinical examination was performed and urinary tract infection was ruled out using a urine test strip. After diagnosis, antimuscarinic treatment for OAB was prescribed and a follow-up visit was scheduled.At the scheduled first follow-up visit, three months after time of diagnosis and start of treatment, those patients who fulfilled the selection criteria stated above were included. Adherence to fesoterodine treatment was measured using the Morisky–Green test<a class="elsevierStyleCrossRef" href="#bib0255">17</a> adapted and validated for the Spanish language.<a class="elsevierStyleCrossRef" href="#bib0260">18</a> In addition, patients were asked how many pills they had taken. The main reasons for lack of adherence or treatment discontinuation and potential factors influencing adherence were also recorded at the only study visit. Patient-Reported-Treatment benefit [Treatment Benefit Scale (TBS)],<a class="elsevierStyleCrossRef" href="#bib0265">19</a> OAB-qSF and ICIQ-UI-SF were recorded to assess the patient-reported outcomes after three months of therapy.All study participants provided their written informed consent. In accordance with the Spanish recommendations, the study was approved by the Clinical Research Ethics Committee of Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.Measurements and instrumentsThe Morisky–Green questionnaire<a class="elsevierStyleCrossRefs" href="#bib0255">17,18</a> is a four-question survey to assess the patient's treatment adherence. A person was considered to be non-adherent if they responded affirmatively to at least one question. In addition, patients who declared forgetting to take medication were asked what the proportion of drug they did not take (>75%; 75–50%; 50–25%; <25%).The TBS<a class="elsevierStyleCrossRef" href="#bib0265">19</a> is a self-administered single-item instrument, used to compare the current state of their urinary problems with their state before the start of the treatment. It is scored from 1 to 4 (1=greatly improved, 2=improved, 3=no change, 4=worsened during the treatment).The OAB-qSF<a class="elsevierStyleCrossRef" href="#bib0250">16</a> evaluates patient-perceived bother occasioned by the symptoms and their impact on health-related quality of life (HR-QOL). It consists of a 6-item symptom bother scale and a 13-item quality of life scale. The total score on the symptom bother scale ranges from 0 (not at all) to 100 (a very great deal). The total score on the quality of life scale ranges from 0 to 100; the higher the score, the better the quality of life.ICIQ-UI-SF<a class="elsevierStyleCrossRef" href="#bib0245">15</a> is a four-question survey to assess the urinary incontinence severity. Total scores range from 0 to 21 (1–5 mild; 6–12 moderate; 13–21 severe).Statistical analysisThe descriptive analysis included demographic and clinical characteristics of patients. Quantitative and qualitative variables were analyzed using measurements of central tendency (mean, median) and of dispersion (95% confidence interval [CI]). Student's t-test or Mann–Whitney U test were used to compare quantitative variables and Pearson's Chi-square or Fisher exact tests for qualitative variables. Variables: age, educational level, place of residence (urban, rural), number of concomitant drugs, place of healthcare attention (primary care, hospital setting), ICIQ-UI-SF and OABqSF scores at prescription time, were screened as potential factors influencing adherence using univariate analysis and then assessed using logistic regression. Tests were two-tailed with a significance level of 5%. Data were analyzed using SPSS V17.0 statistical software.ResultsOne hundred and twenty patients who suffered from severe OAB at diagnosis according to the ICIQ-SF [mean (SD) score 13.2 (4.0)] were included in the study. <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a> summarizes the baseline patient characteristics at the time of initiation of the OAB therapy.<elsevierMultimedia ident="tbl0005"></elsevierMultimedia>Of the total patients, 107 women who answered the Morisky–Green test were included in adherence analysis. According to the Morisky–Green test, 42.1% of the patients (n=45) were classified as compliant or adherent, while the remaining 57.9% of the patients (n=62) were considered non-compliant with the treatment.Compliant patients took a mean (SD) of 87.0 (39.5) fesoterodine tablets compared with the 62.7 (60.5) taken by non-compliant patients (p<0.05). 30 of the 62 non-compliant patients indicated the proportion of drug they forgot to take: most women (63.3%, 19/30) forgot to take less than 25% of their prescribed drug, 2 (6.7%) 25–50%, 4 (13.3%) did not take 50–75%, and 5 (16.7%) more than 75%.Reasons for lack of compliance or discontinuation with fesoterodine treatment were available on 45 of 62 non-compliant women; some patients reported more than one reason. Side effects were the main cause (62.2%), followed by lack of clinical benefits (20.0%; <a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>). Among the other causes stated, patient's neglect (11.1%) and clinical improvement (6.6%) were the most frequent (<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>). The main side effects reported (>10% patients) as the reason for lack of adherence included dry mouth (10/27; 37.0%) and constipation (3/27; 11.1%).<elsevierMultimedia ident="tbl0010"></elsevierMultimedia>No significant differences were observed between patients with and without adherence to treatment regarding any of the potential factors influencing adherence analyzed (age, educational level, place of residence, number of concomitant drugs, place of healthcare attention, ICIQ-UI-SF and OABqSF scores at prescription time; <a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>). Therefore, subsequent logistic regression analysis was not performed.<elsevierMultimedia ident="tbl0015"></elsevierMultimedia><a class="elsevierStyleCrossRef" href="#tbl0020">Table 4</a> summarizes the patient-reported outcomes. The proportion of patients who reported improvement (greatly improved/improved) according to TBS was greater among compliant patients (73.3%) compared with non-compliant (62.9%); however, no significant inter-group differences were observed (p>0.05). At the time of diagnosis, significant differences in total ICIQ-SF and OAB-qSF scores were not observed between compliant and non-compliant patients (p>0.05). Three months after fesoterodine prescription, patient-perceived bother occasioned by the OAB symptoms and their impact on health-related quality of life as well as OAB severity showed a significant improvement (p<0.0001, <a class="elsevierStyleCrossRef" href="#tbl0020">Table 4</a>). Significant differences were not observed amongst compliant and non-compliant patients after three months of treatment (p>0.05).<elsevierMultimedia ident="tbl0020"></elsevierMultimedia>DiscussionMedication adherence plays a key role in patients with OAB. OAB patients who discontinue treatment prematurely are unable to obtain the full benefit of therapy.<a class="elsevierStyleCrossRef" href="#bib0270">20</a> As seen with patients with other chronic conditions, adherence and persistence to antimuscarinic therapy is very poor.<a class="elsevierStyleCrossRef" href="#bib0275">21</a>Several reports have assessed adherence rates to different antimuscarinic therapies,<a class="elsevierStyleCrossRefs" href="#bib0230">12,20</a> but only a few include real-world fesoterodine data,<a class="elsevierStyleCrossRefs" href="#bib0215">9,13,22</a> one of the most widely used antimuscarinic drugs in Spain, together with tolterodine and solifenacin.Definitions and calculation of adherence are not uniform across the literature. The present report shows a high short-term adherence rate of 42% in a sample of new users of fesoterodine with severe OAB. In a post hoc analysis from the IMPACTA study,<a class="elsevierStyleCrossRef" href="#bib0285">23</a> Castro-Díaz et al.<a class="elsevierStyleCrossRef" href="#bib0215">9</a> reported a two-month fesoterodine adherence measured also by the Morisky–Green test of 31%.<a class="elsevierStyleCrossRef" href="#bib0215">9</a> A Norwegian retrospective analysis of a pharmacy claims database,<a class="elsevierStyleCrossRef" href="#bib0280">22</a> evaluated adherence to tolterodine, solifenacin, darifenacin, and fesoterodine using the medication possession rate (MPR); the new users of fesoterodine were the most adherent with an annual adherence rate of 38.5% for MPR≥0.8.Adherence to treatment is achieved when a good balance exists between tolerability, efficacy, and cost of treatment. In contrast to previous studies where lack of efficacy was the most frequent cause of discontinuation,<a class="elsevierStyleCrossRefs" href="#bib0285">23,24</a> in our study, in agreement with Dmochowski et al.,<a class="elsevierStyleCrossRef" href="#bib0295">25</a> lack of compliance or discontinuation was more often due to intolerance than inefficacy. In line with several previous studies,<a class="elsevierStyleCrossRefs" href="#bib0295">25,26</a> the main side effects here reported were dry mouth (25.0%) and constipation (11.1%). Thus, actions aimed at offsetting these common side effects such as providing adequate information that will allow the patients to have a more realistic view of the treatment tolerance, an early detection of AEs, and an effective implementation of management strategies that can reduce patient discomfort might improve patient compliance and support optimal clinical outcomes.We believe, as other authors have reported, that inadequate symptom control, unmet or unrealistic expectations and inadequate follow-up after initiation of therapy could be other important factors influencing adherence to medication.<a class="elsevierStyleCrossRef" href="#bib0240">14</a> Therefore, a better patient–physician communication is necessary to improve treatment adherence. Recently, the Global Development of Self-Assessment Goal Achieved (SAGA)<a class="elsevierStyleCrossRef" href="#bib0305">27</a> questionnaire, which provides a basis for the patients and physicians to discuss realistic treatment expectations, has been reported. A mismatch between treatment expectations and outcomes can lead to patients’ dissatisfaction and discontinuation of medication<a class="elsevierStyleCrossRef" href="#bib0310">28</a> of which the physician may be unaware.<a class="elsevierStyleCrossRef" href="#bib0315">29</a> Physicians must provide good information about OAB treatment that will allow the patients to have realistic expectations about its efficacy and tolerability. A short-time appointment to ensure adequate understanding of instructions and help solve initial problems with medication might be helpful, too.Establishing factors that predispose patients to be compliant with their medication is also crucial for effective OAB therapy. Several retrospective studies have found that rates of adherence were higher in patients taking extended-release formulations<a class="elsevierStyleCrossRefs" href="#bib0230">12,30</a> and in older people.<a class="elsevierStyleCrossRef" href="#bib0230">12</a> Poor compliance can be attributed to other factors, including low levels of formal education, cultural factors, side effects, and financial barriers.<a class="elsevierStyleCrossRef" href="#bib0320">30</a> In the present study, contrary to what was expected, associations were not observed between the demographic/clinical factors analyzed and compliance with treatment.Fesoterodine has shown significantly improved OAB symptoms and health-related quality of life of OAB patients in several clinical trials.<a class="elsevierStyleCrossRef" href="#bib0325">31</a> The patient's perception of treatment benefit and the effects on their quality of life often impacts on whether or not a patient will continue with OAB therapy.<a class="elsevierStyleCrossRef" href="#bib0300">26</a> In consonance with the results reported in other real-life studies,<a class="elsevierStyleCrossRefs" href="#bib0215">9,32</a> in the present study, where a high adherence rate was achieved, the illness status as well as the patient-perceived bother occasioned by the symptoms and the impact on their quality of life improved significantly three months after starting fesoterodine treatment. Furthermore, according to TBS, most compliant patients (73.3%) reported an improvement of their urinary symptoms when compared to their baseline status before the start of treatment.Nevertheless, non-compliant patients in the present study reported having achieved similar therapeutic benefit to those observed in compliant patients. Choo et al. indicated that although four weeks after discontinuing treatment all the voiding parameters decreased significantly, these remained improved compared with baseline.<a class="elsevierStyleCrossRef" href="#bib0335">33</a> Therefore, it could be possible that this group of patients with a drug intake of nearly 70% of the total prescribed treatment discontinued at dates close to the inclusion visit, so they retained the benefit of the medication taken.Some limitations in our analysis must be considered. The Morisky–Green test was fulfilled by the patients in the presence of the attending physician or therapist. It is known that patients may not answer truthfully under these circumstances. However, the subjective nature of this test allows for the obtainment of qualitative data of the reasons for discontinuation, which is one of the strengths of the present study. Furthermore, we used a validated Spanish version of the test. Another limitation of our study was that adherence was measured 12 weeks after prescription which precludes further conclusions regarding adherence in the long-term. However, a dramatic fall in adherence is observed during the first three months after drug prescription. Shaya et al. in a large medicaid population study<a class="elsevierStyleCrossRef" href="#bib0320">30</a> showed that 56% of patients abandoned antimuscarinic treatment during the first month after prescription. In addition, Chancellor et al.<a class="elsevierStyleCrossRef" href="#bib0340">34</a> showed that about 33% of patients fail early to comply with treatment (within the first 30 days). Therefore, research is needed to understand the reasons for low persistence during this initial period, so that interventions can be developed to improve persistence and compliance. Lastly, in this study the time in which treatment discontinuation occurred was not recorded.ConclusionsThis study has shown that adherence to fesoterodine treatment at three months of prescription was 42% in routine clinical practice. The main reasons for non-compliance were side effects (dry mouth and constipation), followed by lack of efficacy. Amongst those who discontinued or did not comply with treatment, nearly three quarters had completed more than half the total treatment prescribed.Conflict of interestAll authors declare that they have no competing interests." "textoCompletoSecciones" => array:1 [ "secciones" => array:12 [ 0 => array:3 [ "identificador" => "xres485643" "titulo" => "Abstract" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Objectives" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Methods" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusion" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec507913" "titulo" => "Keywords" ] 2 => array:3 [ "identificador" => "xres485644" "titulo" => "Resumen" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0025" "titulo" => "Objetivos" ] 1 => array:2 [ "identificador" => "abst0030" "titulo" => "Métodos" ] 2 => array:2 [ "identificador" => "abst0035" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0040" "titulo" => "Conclusión" ] ] ] 3 => array:2 [ "identificador" => "xpalclavsec507914" "titulo" => "Palabras clave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 5 => array:3 [ "identificador" => "sec0010" "titulo" => "Patients and methods" "secciones" => array:3 [ 0 => array:2 [ "identificador" => "sec0015" "titulo" => "Study design and patients" ] 1 => array:2 [ "identificador" => "sec0020" "titulo" => "Measurements and instruments" ] 2 => array:2 [ "identificador" => "sec0025" "titulo" => "Statistical analysis" ] ] ] 6 => array:2 [ "identificador" => "sec0030" "titulo" => "Results" ] 7 => array:2 [ "identificador" => "sec0035" "titulo" => "Discussion" ] 8 => array:2 [ "identificador" => "sec0040" "titulo" => "Conclusions" ] 9 => array:2 [ "identificador" => "sec0045" "titulo" => "Conflict of interest" ] 10 => array:2 [ "identificador" => "xack151085" "titulo" => "Acknowledgments" ] 11 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2014-03-11" "fechaAceptado" => "2014-05-14" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec507913" "palabras" => array:3 [ 0 => "Overactive bladder" 1 => "Adherence" 2 => "Fesoterodine" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec507914" "palabras" => array:3 [ 0 => "Vejiga hiperactiva" 1 => "Adherencia" 2 => "Fesoterodina" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:3 [ "titulo" => "Abstract" "resumen" => "ObjectivesTo assess the short-term compliance with fesoterodine treatment and to identify the reasons for lack of adherence and discontinuation in routine clinical practice. The secondary aim was to estimate the patient-reported outcomes. MethodsThis was an observational retrospective, multicenter study conducted in a sample of women with overactive bladder on fesoterodine treatment for at least three months. Adherence to medication was assessed using the Morisky–Green test. Patient-reported outcomes were assessed using the Incontinence Questionnaire Short Form (ICIQ-SF), Overactive Bladder Questionnaire Short Form (OAB-qSF), and Treatment Benefit Scale (TBS). ResultsOne hundred and twenty women with a mean age [standard deviation (SD)] of 62.2 (12.0) years with severe OAB [mean (SD) ICIQ-SF score 13.2 (4.0)] were included. 42.1% of the patients were considered compliant with fesoterodine treatment. The main causes for non-compliance/discontinuation stated by the remaining 57.9% of the patients were adverse events (62.2%) and lack of clinical benefits (20.0%). The illness status as well as the patient-perceived bother occasioned by the OAB symptoms and their impact on the quality of life improved significantly after three months on fesoterodine treatment (p<0.0001). Most of the patients stated that the current state of their urinary problems had greatly improved/improved. ConclusionIn routine clinical practice, a high percentage of patients were adherent to fesoterodine and perceived the benefit that the treatment provided them three months after starting treatment. However, more than half of the study population failed to comply or discontinued the treatment mainly due to intolerance or lack of efficacy." "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Objectives" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Methods" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusion" ] ] ] "es" => array:3 [ "titulo" => "Resumen" "resumen" => "ObjetivosValorar a corto plazo la adherencia al tratamiento con fesoterodina e identificar las causas de la falta de adherencia o abandono en la práctica clínica diaria. El objetivo secundario fue estimar los resultados desde el punto de vista del paciente. MétodosEste fue un estudio observacional, retrospectivo, y multicéntrico, llevado a cabo en una muestra poblacional de mujeres con vejiga hiperactiva (VH), en tratamiento con fesoterodina durante al menos 3 meses. La adherencia a la medicación se valoró mediante el test Morisky-Green. Los resultados desde el punto de vista del paciente fueron valorados empleando los cuestionarios cortos de incontinencia (ICIQ-SF) y vejiga hiperactiva (OAB-qSF) y la escala del beneficio del tratamiento (TBS). ResultadosSe incluyeron 120 mujeres con una edad media (desviación estándar [DE]) de 62,2 (12,0) años con VH grave según la puntuación media (DE) del ICIQ-SF (13,2 [4,0]). El 42,1% de las pacientes fueron consideradas cumplidoras con el tratamiento de fesoterodina. Las principales causas de incumplimiento/abandono indicadas por el 57,9% restantes fueron los efectos adversos (62,2%) y la falta de beneficio clínico (20,0%). Tanto el grado de enfermedad como las molestias debidas a los síntomas de la VH percibidas por los pacientes y el impacto en su calidad de vida mejoraron significativamente después de 3 meses del tratamiento con fesoterodina (p<0,0001). La mayoría de los pacientes indicaron que sus problemas urinarios habían sufrido una gran mejora o habían mejorado. ConclusiónEn la práctica clínica diaria un elevado porcentaje de pacientes fueron considerados cumplidores con el tratamiento de fesoterodina y percibieron los beneficios que dicho tratamiento proporcionaba después de 3 meses de iniciarlo. Sin embargo, más de la mitad de la población de estudio no cumplió o abandonó el tratamiento debido principalmente a intolerancia o falta de eficacia." "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0025" "titulo" => "Objetivos" ] 1 => array:2 [ "identificador" => "abst0030" "titulo" => "Métodos" ] 2 => array:2 [ "identificador" => "abst0035" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0040" "titulo" => "Conclusión" ] ] ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "Please cite this article as: Simó M, Porta O, Pubill J, Castillo MT, Mora I, Huguet E, et al. Adherencia a fesoterodina en mujeres con vejiga hiperactiva en la práctica clínica diaria. Actas Urol Esp. 2015;39:222–228." ] ] "multimedia" => array:4 [ 0 => array:7 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:2 [ "leyenda" => "SD: standard deviation; OABqSF: OAB Questionnaire Short Form; ICIQ-SF: International Consultation on Incontinence Questionnaire Short Form." "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="" valign="top" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Total (n=120) \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Age, mean (SD) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">62.2 (12.0) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Educational level n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">115 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Without studies \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">10 (8.7) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Primary \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">57 (49.6) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Secondary or higher \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">48 (41.7) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="2" align="left" valign="top"></td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Place of residence, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">118 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Rural (≤10,000 inhabitants) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">10 (8.5) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Semi-urban area (10,000–30,000 inhabitants) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">16 (13.6) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Urban area (>30,000–200,000 inhabitants) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">38 (32.2) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Metropolitan area (>200,000 inhabitants) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">54 (45.8) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="2" align="left" valign="top"></td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Place of health-care attention, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">118 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Primary care \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">12 (10.2) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Hospital setting \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">106 (89.8) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="2" align="left" valign="top"></td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Number of concomitant treatments, mean (SD) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2.6 (2.3) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="2" align="left" valign="top"></td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="2" align="left" valign="top">OABqSF score, mean (SD)</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">OAB bother severity (range 0–100) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">54.8 (17.0) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Quality of life (range 0–100) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">63.8 (19.3) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="2" align="left" valign="top"></td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">ICIQ-SF score (range 0–21), mean (SD) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">13.2 (4.0) \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab769298.png" ] ] ] ] "descripcion" => array:1 [ "en" => "Demographic and clinical characteristics at time of diagnosis." ] ] 1 => array:7 [ "identificador" => "tbl0010" "etiqueta" => "Table 2" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="" valign="top" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Non-compliant (n=45) \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Lack of efficacy, n(%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">9 (20.0) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Adverse events, n(%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">28 (62.2) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Other reasons, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">15 (33.3) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Patient's neglect \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">5 (11.1) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Clinical improvement \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">3 (6.6) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Switch of treatment \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2 (4.4) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Misinterpretation of the treatment \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 (2.2) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">At patient's request \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 (2.2) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Surgery \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 (2.2) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Loss to follow-up \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2 (4.4) \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab769296.png" ] ] ] ] "descripcion" => array:1 [ "en" => "Main reasons for lack of compliance or discontinuation." ] ] 2 => array:7 [ "identificador" => "tbl0015" "etiqueta" => "Table 3" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:2 [ "leyenda" => "SD: standard deviation. OABqSF: OAB Questionnaire Short Form (range 0–100). ICIQ-SF: International Consultation on Incontinence Questionnaire Short Form (range 0–21)." "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="" valign="top" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Compliant (n=45) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Non-compliant (n=62) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">p \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Age, mean (SD) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">62.2 (10.8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">62.2 (12.6) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.743 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="4" align="left" valign="top"></td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Educational level, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">43 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">59 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Without studies \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">5 (11.6) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">5 (8.5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.585 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Primary \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">18 (41.9) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">33 (55.9) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Secondary or higher \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">20 (46.6) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">21 (35.6) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="4" align="left" valign="top"></td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Place of residence, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">45 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">60 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Rural (≤10,000 inhabitants) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">3 (6.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">7 (11.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.408 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Semi-urban area (10,000–30,000 inhabitants) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">6 (13.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">10 (16.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Urban area (>30,000–200,000 inhabitants) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">17 (37.8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">14 (23.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Metropolitan area (>200,000 inhabitants) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">19 (42.2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">29 (48.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="4" align="left" valign="top"></td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Place of health care attention, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">44 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">61 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.274 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Primary care \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">3 (6.8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">8 (13.1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Hospital setting \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">41 (93.2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">53 (86.9) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Number of concomitant treatments, mean (SD) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2.48 (2.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2.8 (2.4) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.436 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="4" align="left" valign="top"></td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">OABqSF score, mean (SD) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">45 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">62 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">OAB bother severity scale \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">56.6 (15.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">53.1 (18.5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.397 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Quality of life scale \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">62.6 (20.4) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">63.4 (20.0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.870 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="4" align="left" valign="top"></td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">ICIQ-SF score, mean (SD) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">13.3 (4.1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">12.7 (4.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.685 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab769297.png" ] ] ] ] "descripcion" => array:1 [ "en" => "Potential factors influencing to adherence at time of prescription." ] ] 3 => array:7 [ "identificador" => "tbl0020" "etiqueta" => "Table 4" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:3 [ "leyenda" => "SD: standard deviation; TBS: Treatment Benefit Scale; OABqSF: Overactive Bladder Questionnaire Short Form (range 0–100); ICIQ-SF: International Consultation on Incontinence Questionnaire Short Form (range 0–21)." "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="" valign="top" scope="col"> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " colspan="3" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">At time of diagnosis</th><th class="td" title="table-head " colspan="3" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">3 months after prescription</th></tr><tr title="table-row"><th class="td" title="table-head " align="" valign="top" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Compliant (n=45) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Non-compliant (n=62) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">p \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Compliant (n=45) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Non-compliant (n=62) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">p \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry " colspan="7" align="left" valign="top">TBS, n (%)</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Greatly improved \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">– \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">– \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">9 (20.0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">17 (27.4) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.743 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Improved \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">24 (53.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">22 (35.5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">No change \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">12 (26.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">23 (37.1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Worsened \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0 (0.0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0 (0.0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="7" align="left" valign="top"></td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="7" align="left" valign="top">OAB-qSF score, mean (SD)</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><a class="elsevierStyleCrossRef" href="#tblfn0005">*</a>Bother scale \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">56.0 (15.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">53.1 (18.5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.397 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">34.9 (22.5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">34.5 (20.9) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.934 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><a class="elsevierStyleCrossRef" href="#tblfn0005">*</a>Quality of life scale \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">62.6 (20.4) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">63.4 (20.0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.870 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">75.5 (16.8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">75.9 (18.5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.693 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="7" align="left" valign="top"></td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><a class="elsevierStyleCrossRef" href="#tblfn0005">*</a>ICIQ-SF, mean score (SD) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">13.3 (4.1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">12.7 (4.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.685 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">9.33 (5.2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">9.79 (5.42) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.604 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab769299.png" ] ] ] "notaPie" => array:1 [ 0 => array:3 [ "identificador" => "tblfn0005" "etiqueta" => "*" "nota" => "p intra-group at time of diagnosis vs. months after prescription <0.0001." ] ] ] "descripcion" => array:1 [ "en" => "Patient-reported outcomes." ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:34 [ 0 => array:3 [ "identificador" => "bib0175" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The standardisation of terminology of lower urinary tract function: report from the standardisation sub-committee of the International Continence Society" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "P. 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Adherence to fesoterodine in women with overactive bladder in routine clinical practice

Adherencia a fesoterodina en mujeres con vejiga hiperactiva en la práctica clínica diaria

M. Simóa,

Corresponding author

msimo@santpau.cat

Corresponding author.

, O. Portaa, J. Pubillb, M.T. Castilloc, I. Morad, E. Huguete, J.A. Ortegaf, E. Martínezg

a Departamento de Obstetricia y Ginecología, Hospital de Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain

b Departamento de Obstetricia y Ginecología, Corporació Sanitària Parc Taulí, Barcelona, Spain

c Departamento de Obstetricia y Ginecología, Parc de Salut Mar, Barcelona, Spain

d Departamento de Obstetricia y Ginecología, Hospital d’Igualada, Barcelona, Spain

e Departamento de Obstetricia y Ginecología, Hospital Viladecans, Barcelona, Spain

f PASSIR Dreta, Institut Català de la Salut, Barcelona, Spain

g Departamento de Obstetricia y Ginecología, Parc Sanitari Sant Joan de Déu Sant Boi, Barcelona, Spain

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    "titulosAlternativos" => array:1 [
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        "titulo" => "Adherencia a fesoterodina en mujeres con vejiga hiperactiva en la pr&#225;ctica cl&#237;nica diaria"
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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Overactive bladder &#40;OAB&#41; is a common chronic condition&#44; characterized by urinary urgency with or without urge incontinence&#44; often with increased daytime frequency and nocturia&#46;<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">1</span></a> In Spain&#44; OAB prevalence rates of 5&#46;9&#8211;11&#46;8&#37; have been reported for women&#46;<a class="elsevierStyleCrossRefs" href="#bib0180"><span class="elsevierStyleSup">2&#44;3</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">The symptoms associated with OAB have an adverse impact on several aspects of health-related quality of life &#40;HRQL&#41; in adult women of all ages&#44;<a class="elsevierStyleCrossRef" href="#bib0190"><span class="elsevierStyleSup">4</span></a> including physical function&#44; emotional well-being&#44; sexual relationship&#44; and work productivity&#46;<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">5</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">Antimuscarinic agents are the pharmacological mainstay of OAB treatment&#46;<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">6</span></a> Fesoterodine&#44; a nonselective oral antimuscarinic agent&#44; has shown to be effective and well tolerated&#46;<a class="elsevierStyleCrossRef" href="#bib0205"><span class="elsevierStyleSup">7</span></a> In addition&#44; the availability of two doses of fesoterodine provides an opportunity to establish an optimal balance between efficacy and tolerability in individual patients&#46;<a class="elsevierStyleCrossRefs" href="#bib0210"><span class="elsevierStyleSup">8&#44;9</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">For pharmacotherapy to be beneficial&#44; good persistence and adherence are essential&#46; Poor persistence with long-term medication in chronic diseases is common&#46;<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">10</span></a> For overactive bladder&#44; however&#44; medication persistence is lower than average&#46;<a class="elsevierStyleCrossRef" href="#bib0225"><span class="elsevierStyleSup">11</span></a> In studies that have a 6-month follow-up&#44; antimuscarinic persistence rates of 11&#8211;30&#37; have been reported and in studies with at least 1 year&#39;s follow-up&#44; persistence rates range from 8&#37; to 29&#37;&#46;<a class="elsevierStyleCrossRef" href="#bib0230"><span class="elsevierStyleSup">12</span></a> Persistence may vary among antimuscarinic agents&#46;<a class="elsevierStyleCrossRefs" href="#bib0230"><span class="elsevierStyleSup">12&#44;13</span></a> A retrospective study&#44; carried out with medical records from Spanish primary healthcare centers&#44; reported a cumulative probability of persisting with initial therapy significantly higher for fesoterodine than for solifenacin or tolterodine&#46;<a class="elsevierStyleCrossRef" href="#bib0235"><span class="elsevierStyleSup">13</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">On the other hand&#44; clinical practice suggests that adherence rates reported in clinical trials are much higher than in real practice&#46;<a class="elsevierStyleCrossRef" href="#bib0230"><span class="elsevierStyleSup">12</span></a> Trial subjects receive intensive follow-up and incentives which encourage adherence&#44; so they might not be representative of the general population treated in normal clinical practice&#46;<a class="elsevierStyleCrossRef" href="#bib0240"><span class="elsevierStyleSup">14</span></a> Non-interventional studies&#44; as the one we present here&#44; may therefore provide complementary information to clinical trials&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">Despite well-established efficacy of fesoterodine in clinical trials&#44; treatment non-compliance is a major obstacle to its effectiveness in clinical practice&#46; Identification of reasons for non-compliance&#47;discontinuation of fesoterodine medication provides an opportunity to tailor strategies aimed at improving patient compliance with treatment&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">We carried out a study aimed at evaluating the short-term adherence to fesoterodine treatment among women diagnosed with overactive bladder &#40;OAB&#41; and identifying the reasons for lack of adherence and the potential factors influencing adherence&#46; The secondary aim was to assess the short-term patient-reported outcomes in routine clinical practice&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Patients and methods</span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Study design and patients</span><p id="par0040" class="elsevierStylePara elsevierViewall">This is an observational and retrospective study conducted at six hospitals and one primary care center of Barcelona&#44; Spain&#46; Eligibility criteria included adult women diagnosed with OAB according to the International Continence Society &#40;ICS&#41; definition&#44; without pelvic organ prolapse &#40;&#8804;stage II Baden-Walker&#41;&#44; with absence of symptoms or signs of urinary tract infection&#44; new users of fesoterodine 4<span class="elsevierStyleHsp" style=""></span>mg without dose-escalation to 8<span class="elsevierStyleHsp" style=""></span>mg&#44; and on treatment for at least three months&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">The study was of a non-intervention nature&#44; and the OAB treatment prescribed was determined by the clinical judgment of the doctor responsible for the patient&#39;s management&#46; At the time of diagnosis&#44; as in routine clinical practice&#44; patients completed the validated Spanish version of the International Consultation on Incontinence Questionnaire Short Form &#40;ICIQ-UI-SF&#41;<a class="elsevierStyleCrossRef" href="#bib0245"><span class="elsevierStyleSup">15</span></a> to assess OAB severity and the Overactive Bladder Questionnaire Short Form &#40;OAB-qSF&#41;<a class="elsevierStyleCrossRef" href="#bib0250"><span class="elsevierStyleSup">16</span></a> to evaluate impact of OAB on their lives&#46; Clinical examination was performed and urinary tract infection was ruled out using a urine test strip&#46; After diagnosis&#44; antimuscarinic treatment for OAB was prescribed and a follow-up visit was scheduled&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">At the scheduled first follow-up visit&#44; three months after time of diagnosis and start of treatment&#44; those patients who fulfilled the selection criteria stated above were included&#46; Adherence to fesoterodine treatment was measured using the Morisky&#8211;Green test<a class="elsevierStyleCrossRef" href="#bib0255"><span class="elsevierStyleSup">17</span></a> adapted and validated for the Spanish language&#46;<a class="elsevierStyleCrossRef" href="#bib0260"><span class="elsevierStyleSup">18</span></a> In addition&#44; patients were asked how many pills they had taken&#46; The main reasons for lack of adherence or treatment discontinuation and potential factors influencing adherence were also recorded at the only study visit&#46; Patient-Reported-Treatment benefit &#91;Treatment Benefit Scale &#40;TBS&#41;&#93;&#44;<a class="elsevierStyleCrossRef" href="#bib0265"><span class="elsevierStyleSup">19</span></a> OAB-qSF and ICIQ-UI-SF were recorded to assess the patient-reported outcomes after three months of therapy&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">All study participants provided their written informed consent&#46; In accordance with the Spanish recommendations&#44; the study was approved by the Clinical Research Ethics Committee of Hospital de la Santa Creu i Sant Pau&#44; Barcelona&#44; Spain&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Measurements and instruments</span><p id="par0060" class="elsevierStylePara elsevierViewall">The Morisky&#8211;Green questionnaire<a class="elsevierStyleCrossRefs" href="#bib0255"><span class="elsevierStyleSup">17&#44;18</span></a> is a four-question survey to assess the patient&#39;s treatment adherence&#46; A person was considered to be non-adherent if they responded affirmatively to at least one question&#46; In addition&#44; patients who declared forgetting to take medication were asked what the proportion of drug they did not take &#40;&#62;75&#37;&#59; 75&#8211;50&#37;&#59; 50&#8211;25&#37;&#59; &#60;25&#37;&#41;&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">The TBS<a class="elsevierStyleCrossRef" href="#bib0265"><span class="elsevierStyleSup">19</span></a> is a self-administered single-item instrument&#44; used to compare the current state of their urinary problems with their state before the start of the treatment&#46; It is scored from 1 to 4 &#40;1<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>greatly improved&#44; 2<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>improved&#44; 3<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>no change&#44; 4<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>worsened during the treatment&#41;&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">The OAB-qSF<a class="elsevierStyleCrossRef" href="#bib0250"><span class="elsevierStyleSup">16</span></a> evaluates patient-perceived bother occasioned by the symptoms and their impact on health-related quality of life &#40;HR-QOL&#41;&#46; It consists of a 6-item symptom bother scale and a 13-item quality of life scale&#46; The total score on the symptom bother scale ranges from 0 &#40;not at all&#41; to 100 &#40;a very great deal&#41;&#46; The total score on the quality of life scale ranges from 0 to 100&#59; the higher the score&#44; the better the quality of life&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">ICIQ-UI-SF<a class="elsevierStyleCrossRef" href="#bib0245"><span class="elsevierStyleSup">15</span></a> is a four-question survey to assess the urinary incontinence severity&#46; Total scores range from 0 to 21 &#40;1&#8211;5 mild&#59; 6&#8211;12 moderate&#59; 13&#8211;21 severe&#41;&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Statistical analysis</span><p id="par0080" class="elsevierStylePara elsevierViewall">The descriptive analysis included demographic and clinical characteristics of patients&#46; Quantitative and qualitative variables were analyzed using measurements of central tendency &#40;mean&#44; median&#41; and of dispersion &#40;95&#37; confidence interval &#91;CI&#93;&#41;&#46; Student&#39;s <span class="elsevierStyleItalic">t</span>-test or Mann&#8211;Whitney <span class="elsevierStyleItalic">U</span> test were used to compare quantitative variables and Pearson&#39;s Chi-square or Fisher exact tests for qualitative variables&#46; Variables&#58; age&#44; educational level&#44; place of residence &#40;urban&#44; rural&#41;&#44; number of concomitant drugs&#44; place of healthcare attention &#40;primary care&#44; hospital setting&#41;&#44; ICIQ-UI-SF and OABqSF scores at prescription time&#44; were screened as potential factors influencing adherence using univariate analysis and then assessed using logistic regression&#46; Tests were two-tailed with a significance level of 5&#37;&#46; Data were analyzed using SPSS V17&#46;0 statistical software&#46;</p></span></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Results</span><p id="par0085" class="elsevierStylePara elsevierViewall">One hundred and twenty patients who suffered from severe OAB at diagnosis according to the ICIQ-SF &#91;mean &#40;SD&#41; score 13&#46;2 &#40;4&#46;0&#41;&#93; were included in the study&#46; <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a> summarizes the baseline patient characteristics at the time of initiation of the OAB therapy&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0090" class="elsevierStylePara elsevierViewall">Of the total patients&#44; 107 women who answered the Morisky&#8211;Green test were included in adherence analysis&#46; According to the Morisky&#8211;Green test&#44; 42&#46;1&#37; of the patients &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>45&#41; were classified as compliant or adherent&#44; while the remaining 57&#46;9&#37; of the patients &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>62&#41; were considered non-compliant with the treatment&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">Compliant patients took a mean &#40;SD&#41; of 87&#46;0 &#40;39&#46;5&#41; fesoterodine tablets compared with the 62&#46;7 &#40;60&#46;5&#41; taken by non-compliant patients &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;05&#41;&#46; 30 of the 62 non-compliant patients indicated the proportion of drug they forgot to take&#58; most women &#40;63&#46;3&#37;&#44; 19&#47;30&#41; forgot to take less than 25&#37; of their prescribed drug&#44; 2 &#40;6&#46;7&#37;&#41; 25&#8211;50&#37;&#44; 4 &#40;13&#46;3&#37;&#41; did not take 50&#8211;75&#37;&#44; and 5 &#40;16&#46;7&#37;&#41; more than 75&#37;&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">Reasons for lack of compliance or discontinuation with fesoterodine treatment were available on 45 of 62 non-compliant women&#59; some patients reported more than one reason&#46; Side effects were the main cause &#40;62&#46;2&#37;&#41;&#44; followed by lack of clinical benefits &#40;20&#46;0&#37;&#59; <a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#41;&#46; Among the other causes stated&#44; patient&#39;s neglect &#40;11&#46;1&#37;&#41; and clinical improvement &#40;6&#46;6&#37;&#41; were the most frequent &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#41;&#46; The main side effects reported &#40;&#62;10&#37; patients&#41; as the reason for lack of adherence included dry mouth &#40;10&#47;27&#59; 37&#46;0&#37;&#41; and constipation &#40;3&#47;27&#59; 11&#46;1&#37;&#41;&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0105" class="elsevierStylePara elsevierViewall">No significant differences were observed between patients with and without adherence to treatment regarding any of the potential factors influencing adherence analyzed &#40;age&#44; educational level&#44; place of residence&#44; number of concomitant drugs&#44; place of healthcare attention&#44; ICIQ-UI-SF and OABqSF scores at prescription time&#59; <a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>&#41;&#46; Therefore&#44; subsequent logistic regression analysis was not performed&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0110" class="elsevierStylePara elsevierViewall"><a class="elsevierStyleCrossRef" href="#tbl0020">Table 4</a> summarizes the patient-reported outcomes&#46; The proportion of patients who reported improvement &#40;greatly improved&#47;improved&#41; according to TBS was greater among compliant patients &#40;73&#46;3&#37;&#41; compared with non-compliant &#40;62&#46;9&#37;&#41;&#59; however&#44; no significant inter-group differences were observed &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>0&#46;05&#41;&#46; At the time of diagnosis&#44; significant differences in total ICIQ-SF and OAB-qSF scores were not observed between compliant and non-compliant patients &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>0&#46;05&#41;&#46; Three months after fesoterodine prescription&#44; patient-perceived bother occasioned by the OAB symptoms and their impact on health-related quality of life as well as OAB severity showed a significant improvement &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;0001&#44; <a class="elsevierStyleCrossRef" href="#tbl0020">Table 4</a>&#41;&#46; Significant differences were not observed amongst compliant and non-compliant patients after three months of treatment &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>0&#46;05&#41;&#46;</p><elsevierMultimedia ident="tbl0020"></elsevierMultimedia></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Discussion</span><p id="par0115" class="elsevierStylePara elsevierViewall">Medication adherence plays a key role in patients with OAB&#46; OAB patients who discontinue treatment prematurely are unable to obtain the full benefit of therapy&#46;<a class="elsevierStyleCrossRef" href="#bib0270"><span class="elsevierStyleSup">20</span></a> As seen with patients with other chronic conditions&#44; adherence and persistence to antimuscarinic therapy is very poor&#46;<a class="elsevierStyleCrossRef" href="#bib0275"><span class="elsevierStyleSup">21</span></a></p><p id="par0120" class="elsevierStylePara elsevierViewall">Several reports have assessed adherence rates to different antimuscarinic therapies&#44;<a class="elsevierStyleCrossRefs" href="#bib0230"><span class="elsevierStyleSup">12&#44;20</span></a> but only a few include real-world fesoterodine data&#44;<a class="elsevierStyleCrossRefs" href="#bib0215"><span class="elsevierStyleSup">9&#44;13&#44;22</span></a> one of the most widely used antimuscarinic drugs in Spain&#44; together with tolterodine and solifenacin&#46;</p><p id="par0125" class="elsevierStylePara elsevierViewall">Definitions and calculation of adherence are not uniform across the literature&#46; The present report shows a high short-term adherence rate of 42&#37; in a sample of new users of fesoterodine with severe OAB&#46; In a post hoc analysis from the IMPACTA study&#44;<a class="elsevierStyleCrossRef" href="#bib0285"><span class="elsevierStyleSup">23</span></a> Castro-D&#237;az et al&#46;<a class="elsevierStyleCrossRef" href="#bib0215"><span class="elsevierStyleSup">9</span></a> reported a two-month fesoterodine adherence measured also by the Morisky&#8211;Green test of 31&#37;&#46;<a class="elsevierStyleCrossRef" href="#bib0215"><span class="elsevierStyleSup">9</span></a> A Norwegian retrospective analysis of a pharmacy claims database&#44;<a class="elsevierStyleCrossRef" href="#bib0280"><span class="elsevierStyleSup">22</span></a> evaluated adherence to tolterodine&#44; solifenacin&#44; darifenacin&#44; and fesoterodine using the medication possession rate &#40;MPR&#41;&#59; the new users of fesoterodine were the most adherent with an annual adherence rate of 38&#46;5&#37; for MPR<span class="elsevierStyleHsp" style=""></span>&#8805;<span class="elsevierStyleHsp" style=""></span>0&#46;8&#46;</p><p id="par0130" class="elsevierStylePara elsevierViewall">Adherence to treatment is achieved when a good balance exists between tolerability&#44; efficacy&#44; and cost of treatment&#46; In contrast to previous studies where lack of efficacy was the most frequent cause of discontinuation&#44;<a class="elsevierStyleCrossRefs" href="#bib0285"><span class="elsevierStyleSup">23&#44;24</span></a> in our study&#44; in agreement with Dmochowski et al&#46;&#44;<a class="elsevierStyleCrossRef" href="#bib0295"><span class="elsevierStyleSup">25</span></a> lack of compliance or discontinuation was more often due to intolerance than inefficacy&#46; In line with several previous studies&#44;<a class="elsevierStyleCrossRefs" href="#bib0295"><span class="elsevierStyleSup">25&#44;26</span></a> the main side effects here reported were dry mouth &#40;25&#46;0&#37;&#41; and constipation &#40;11&#46;1&#37;&#41;&#46; Thus&#44; actions aimed at offsetting these common side effects such as providing adequate information that will allow the patients to have a more realistic view of the treatment tolerance&#44; an early detection of AEs&#44; and an effective implementation of management strategies that can reduce patient discomfort might improve patient compliance and support optimal clinical outcomes&#46;</p><p id="par0135" class="elsevierStylePara elsevierViewall">We believe&#44; as other authors have reported&#44; that inadequate symptom control&#44; unmet or unrealistic expectations and inadequate follow-up after initiation of therapy could be other important factors influencing adherence to medication&#46;<a class="elsevierStyleCrossRef" href="#bib0240"><span class="elsevierStyleSup">14</span></a> Therefore&#44; a better patient&#8211;physician communication is necessary to improve treatment adherence&#46; Recently&#44; the Global Development of Self-Assessment Goal Achieved &#40;SAGA&#41;<a class="elsevierStyleCrossRef" href="#bib0305"><span class="elsevierStyleSup">27</span></a> questionnaire&#44; which provides a basis for the patients and physicians to discuss realistic treatment expectations&#44; has been reported&#46; A mismatch between treatment expectations and outcomes can lead to patients&#8217; dissatisfaction and discontinuation of medication<a class="elsevierStyleCrossRef" href="#bib0310"><span class="elsevierStyleSup">28</span></a> of which the physician may be unaware&#46;<a class="elsevierStyleCrossRef" href="#bib0315"><span class="elsevierStyleSup">29</span></a> Physicians must provide good information about OAB treatment that will allow the patients to have realistic expectations about its efficacy and tolerability&#46; A short-time appointment to ensure adequate understanding of instructions and help solve initial problems with medication might be helpful&#44; too&#46;</p><p id="par0140" class="elsevierStylePara elsevierViewall">Establishing factors that predispose patients to be compliant with their medication is also crucial for effective OAB therapy&#46; Several retrospective studies have found that rates of adherence were higher in patients taking extended-release formulations<a class="elsevierStyleCrossRefs" href="#bib0230"><span class="elsevierStyleSup">12&#44;30</span></a> and in older people&#46;<a class="elsevierStyleCrossRef" href="#bib0230"><span class="elsevierStyleSup">12</span></a> Poor compliance can be attributed to other factors&#44; including low levels of formal education&#44; cultural factors&#44; side effects&#44; and financial barriers&#46;<a class="elsevierStyleCrossRef" href="#bib0320"><span class="elsevierStyleSup">30</span></a> In the present study&#44; contrary to what was expected&#44; associations were not observed between the demographic&#47;clinical factors analyzed and compliance with treatment&#46;</p><p id="par0145" class="elsevierStylePara elsevierViewall">Fesoterodine has shown significantly improved OAB symptoms and health-related quality of life of OAB patients in several clinical trials&#46;<a class="elsevierStyleCrossRef" href="#bib0325"><span class="elsevierStyleSup">31</span></a> The patient&#39;s perception of treatment benefit and the effects on their quality of life often impacts on whether or not a patient will continue with OAB therapy&#46;<a class="elsevierStyleCrossRef" href="#bib0300"><span class="elsevierStyleSup">26</span></a> In consonance with the results reported in other real-life studies&#44;<a class="elsevierStyleCrossRefs" href="#bib0215"><span class="elsevierStyleSup">9&#44;32</span></a> in the present study&#44; where a high adherence rate was achieved&#44; the illness status as well as the patient-perceived bother occasioned by the symptoms and the impact on their quality of life improved significantly three months after starting fesoterodine treatment&#46; Furthermore&#44; according to TBS&#44; most compliant patients &#40;73&#46;3&#37;&#41; reported an improvement of their urinary symptoms when compared to their baseline status before the start of treatment&#46;</p><p id="par0150" class="elsevierStylePara elsevierViewall">Nevertheless&#44; non-compliant patients in the present study reported having achieved similar therapeutic benefit to those observed in compliant patients&#46; Choo et al&#46; indicated that although four weeks after discontinuing treatment all the voiding parameters decreased significantly&#44; these remained improved compared with baseline&#46;<a class="elsevierStyleCrossRef" href="#bib0335"><span class="elsevierStyleSup">33</span></a> Therefore&#44; it could be possible that this group of patients with a drug intake of nearly 70&#37; of the total prescribed treatment discontinued at dates close to the inclusion visit&#44; so they retained the benefit of the medication taken&#46;</p><p id="par0155" class="elsevierStylePara elsevierViewall">Some limitations in our analysis must be considered&#46; The Morisky&#8211;Green test was fulfilled by the patients in the presence of the attending physician or therapist&#46; It is known that patients may not answer truthfully under these circumstances&#46; However&#44; the subjective nature of this test allows for the obtainment of qualitative data of the reasons for discontinuation&#44; which is one of the strengths of the present study&#46; Furthermore&#44; we used a validated Spanish version of the test&#46; Another limitation of our study was that adherence was measured 12 weeks after prescription which precludes further conclusions regarding adherence in the long-term&#46; However&#44; a dramatic fall in adherence is observed during the first three months after drug prescription&#46; Shaya et al&#46; in a large medicaid population study<a class="elsevierStyleCrossRef" href="#bib0320"><span class="elsevierStyleSup">30</span></a> showed that 56&#37; of patients abandoned antimuscarinic treatment during the first month after prescription&#46; In addition&#44; Chancellor et al&#46;<a class="elsevierStyleCrossRef" href="#bib0340"><span class="elsevierStyleSup">34</span></a> showed that about 33&#37; of patients fail early to comply with treatment &#40;within the first 30 days&#41;&#46; Therefore&#44; research is needed to understand the reasons for low persistence during this initial period&#44; so that interventions can be developed to improve persistence and compliance&#46; Lastly&#44; in this study the time in which treatment discontinuation occurred was not recorded&#46;</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Conclusions</span><p id="par0160" class="elsevierStylePara elsevierViewall">This study has shown that adherence to fesoterodine treatment at three months of prescription was 42&#37; in routine clinical practice&#46; The main reasons for non-compliance were side effects &#40;dry mouth and constipation&#41;&#44; followed by lack of efficacy&#46; Amongst those who discontinued or did not comply with treatment&#44; nearly three quarters had completed more than half the total treatment prescribed&#46;</p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Conflict of interest</span><p id="par0165" class="elsevierStylePara elsevierViewall">All authors declare that they have no competing interests&#46;</p></span></span>"
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          "titulo" => "Patients and methods"
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    "fechaRecibido" => "2014-03-11"
    "fechaAceptado" => "2014-05-14"
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        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Keywords"
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          "palabras" => array:3 [
            0 => "Overactive bladder"
            1 => "Adherence"
            2 => "Fesoterodine"
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        0 => array:4 [
          "clase" => "keyword"
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          "palabras" => array:3 [
            0 => "Vejiga hiperactiva"
            1 => "Adherencia"
            2 => "Fesoterodina"
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        "titulo" => "Abstract"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Objectives</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">To assess the short-term compliance with fesoterodine treatment and to identify the reasons for lack of adherence and discontinuation in routine clinical practice&#46; The secondary aim was to estimate the patient-reported outcomes&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Methods</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">This was an observational retrospective&#44; multicenter study conducted in a sample of women with overactive bladder on fesoterodine treatment for at least three months&#46; Adherence to medication was assessed using the Morisky&#8211;Green test&#46; Patient-reported outcomes were assessed using the Incontinence Questionnaire Short Form &#40;ICIQ-SF&#41;&#44; Overactive Bladder Questionnaire Short Form &#40;OAB-qSF&#41;&#44; and Treatment Benefit Scale &#40;TBS&#41;&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">One hundred and twenty women with a mean age &#91;standard deviation &#40;SD&#41;&#93; of 62&#46;2 &#40;12&#46;0&#41; years with severe OAB &#91;mean &#40;SD&#41; ICIQ-SF score 13&#46;2 &#40;4&#46;0&#41;&#93; were included&#46; 42&#46;1&#37; of the patients were considered compliant with fesoterodine treatment&#46; The main causes for non-compliance&#47;discontinuation stated by the remaining 57&#46;9&#37; of the patients were adverse events &#40;62&#46;2&#37;&#41; and lack of clinical benefits &#40;20&#46;0&#37;&#41;&#46; The illness status as well as the patient-perceived bother occasioned by the OAB symptoms and their impact on the quality of life improved significantly after three months on fesoterodine treatment &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;0001&#41;&#46; Most of the patients stated that the current state of their urinary problems had greatly improved&#47;improved&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusion</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">In routine clinical practice&#44; a high percentage of patients were adherent to fesoterodine and perceived the benefit that the treatment provided them three months after starting treatment&#46; However&#44; more than half of the study population failed to comply or discontinued the treatment mainly due to intolerance or lack of efficacy&#46;</p></span>"
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        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Objetivos</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Valorar a corto plazo la adherencia al tratamiento con fesoterodina e identificar las causas de la falta de adherencia o abandono en la pr&#225;ctica cl&#237;nica diaria&#46; El objetivo secundario fue estimar los resultados desde el punto de vista del paciente&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">M&#233;todos</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Este fue un estudio observacional&#44; retrospectivo&#44; y multic&#233;ntrico&#44; llevado a cabo en una muestra poblacional de mujeres con vejiga hiperactiva &#40;VH&#41;&#44; en tratamiento con fesoterodina durante al menos 3 meses&#46; La adherencia a la medicaci&#243;n se valor&#243; mediante el test Morisky-Green&#46; Los resultados desde el punto de vista del paciente fueron valorados empleando los cuestionarios cortos de incontinencia &#40;ICIQ-SF&#41; y vejiga hiperactiva &#40;OAB-qSF&#41; y la escala del beneficio del tratamiento &#40;TBS&#41;&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Se incluyeron 120 mujeres con una edad media &#40;desviaci&#243;n est&#225;ndar &#91;DE&#93;&#41; de 62&#44;2 &#40;12&#44;0&#41; a&#241;os con VH grave seg&#250;n la puntuaci&#243;n media &#40;DE&#41; del ICIQ-SF &#40;13&#44;2 &#91;4&#44;0&#93;&#41;&#46; El 42&#44;1&#37; de las pacientes fueron consideradas cumplidoras con el tratamiento de fesoterodina&#46; Las principales causas de incumplimiento&#47;abandono indicadas por el 57&#44;9&#37; restantes fueron los efectos adversos &#40;62&#44;2&#37;&#41; y la falta de beneficio cl&#237;nico &#40;20&#44;0&#37;&#41;&#46; Tanto el grado de enfermedad como las molestias debidas a los s&#237;ntomas de la VH percibidas por los pacientes y el impacto en su calidad de vida mejoraron significativamente despu&#233;s de 3 meses del tratamiento con fesoterodina &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;0001&#41;&#46; La mayor&#237;a de los pacientes indicaron que sus problemas urinarios hab&#237;an sufrido una gran mejora o hab&#237;an mejorado&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusi&#243;n</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">En la pr&#225;ctica cl&#237;nica diaria un elevado porcentaje de pacientes fueron considerados cumplidores con el tratamiento de fesoterodina y percibieron los beneficios que dicho tratamiento proporcionaba despu&#233;s de 3 meses de iniciarlo&#46; Sin embargo&#44; m&#225;s de la mitad de la poblaci&#243;n de estudio no cumpli&#243; o abandon&#243; el tratamiento debido principalmente a intolerancia o falta de eficacia&#46;</p></span>"
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        "nota" => "<p class="elsevierStyleNotepara" id="npar0010">Please cite this article as&#58; Sim&#243; M&#44; Porta O&#44; Pubill J&#44; Castillo MT&#44; Mora I&#44; Huguet E&#44; et al&#46; Adherencia a fesoterodina en mujeres con vejiga hiperactiva en la pr&#225;ctica cl&#237;nica diaria&#46; Actas Urol Esp&#46; 2015&#59;39&#58;222&#8211;228&#46;</p>"
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          "leyenda" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">SD&#58; standard deviation&#59; OABqSF&#58; OAB Questionnaire Short Form&#59; ICIQ-SF&#58; International Consultation on Incontinence Questionnaire Short Form&#46;</p>"
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                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Total &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>120&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Age&#44; mean &#40;SD&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">62&#46;2 &#40;12&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Educational level n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">115&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Without studies&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">10 &#40;8&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Primary&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">57 &#40;49&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Secondary or higher&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">48 &#40;41&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Place of residence&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">118&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Rural &#40;&#8804;10&#44;000 inhabitants&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">10 &#40;8&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Semi-urban area &#40;10&#44;000&#8211;30&#44;000 inhabitants&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">16 &#40;13&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Urban area &#40;&#62;30&#44;000&#8211;200&#44;000 inhabitants&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">38 &#40;32&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Metropolitan area &#40;&#62;200&#44;000 inhabitants&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">54 &#40;45&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Place of health-care attention&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">118&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Primary care&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">12 &#40;10&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Hospital setting&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">106 &#40;89&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Number of concomitant treatments&#44; mean &#40;SD&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#46;6 &#40;2&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top"><span class="elsevierStyleItalic">OABqSF score&#44; mean &#40;SD&#41;</span></td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>OAB bother severity &#40;range 0&#8211;100&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">54&#46;8 &#40;17&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Quality of life &#40;range 0&#8211;100&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">63&#46;8 &#40;19&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">ICIQ-SF score &#40;range 0&#8211;21&#41;&#44; mean &#40;SD&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">13&#46;2 &#40;4&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
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                0 => "xTab769298.png"
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          "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Demographic and clinical characteristics at time of diagnosis&#46;</p>"
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      1 => array:7 [
        "identificador" => "tbl0010"
        "etiqueta" => "Table 2"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "tabla" => array:1 [
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Non-compliant &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>45&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Lack of efficacy&#44; n&#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">9 &#40;20&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Adverse events&#44; n&#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">28 &#40;62&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Other reasons&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">15 &#40;33&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Patient&#39;s neglect&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5 &#40;11&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Clinical improvement&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3 &#40;6&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Switch of treatment&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2 &#40;4&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Misinterpretation of the treatment&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1 &#40;2&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>At patient&#39;s request&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1 &#40;2&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Surgery&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1 &#40;2&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Loss to follow-up&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2 &#40;4&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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          "en" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Main reasons for lack of compliance or discontinuation&#46;</p>"
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      ]
      2 => array:7 [
        "identificador" => "tbl0015"
        "etiqueta" => "Table 3"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "tabla" => array:2 [
          "leyenda" => "<p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">SD&#58; standard deviation&#46; OABqSF&#58; OAB Questionnaire Short Form &#40;range 0&#8211;100&#41;&#46; ICIQ-SF&#58; International Consultation on Incontinence Questionnaire Short Form &#40;range 0&#8211;21&#41;&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Compliant &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>45&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Non-compliant &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>62&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">p</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Age&#44; mean &#40;SD&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">62&#46;2 &#40;10&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">62&#46;2 &#40;12&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;743&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Educational level&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">43&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">59&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Without studies&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5 &#40;11&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5 &#40;8&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;585&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Primary&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">18 &#40;41&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">33 &#40;55&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Secondary or higher&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">20 &#40;46&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">21 &#40;35&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Place of residence&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">45&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">60&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Rural &#40;&#8804;10&#44;000 inhabitants&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3 &#40;6&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">7 &#40;11&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;408&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Semi-urban area &#40;10&#44;000&#8211;30&#44;000 inhabitants&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6 &#40;13&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">10 &#40;16&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Urban area &#40;&#62;30&#44;000&#8211;200&#44;000 inhabitants&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">17 &#40;37&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">14 &#40;23&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Metropolitan area &#40;&#62;200&#44;000 inhabitants&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">19 &#40;42&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">29 &#40;48&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Place of health care attention&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">44&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">61&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;274&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Primary care&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3 &#40;6&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">8 &#40;13&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Hospital setting&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">41 &#40;93&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">53 &#40;86&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Number of concomitant treatments&#44; mean &#40;SD&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#46;48 &#40;2&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#46;8 &#40;2&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;436&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">OABqSF score&#44; mean &#40;SD&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">45&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">62&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>OAB bother severity scale&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">56&#46;6 &#40;15&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">53&#46;1 &#40;18&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;397&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Quality of life scale&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">62&#46;6 &#40;20&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">63&#46;4 &#40;20&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;870&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">ICIQ-SF score&#44; mean &#40;SD&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">13&#46;3 &#40;4&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">12&#46;7 &#40;4&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;685&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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                0 => "xTab769297.png"
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        "descripcion" => array:1 [
          "en" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Potential factors influencing to adherence at time of prescription&#46;</p>"
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      ]
      3 => array:7 [
        "identificador" => "tbl0020"
        "etiqueta" => "Table 4"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
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        "tabla" => array:3 [
          "leyenda" => "<p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">SD&#58; standard deviation&#59; TBS&#58; Treatment Benefit Scale&#59; OABqSF&#58; Overactive Bladder Questionnaire Short Form &#40;range 0&#8211;100&#41;&#59; ICIQ-SF&#58; International Consultation on Incontinence Questionnaire Short Form &#40;range 0&#8211;21&#41;&#46;</p>"
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                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " colspan="3" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">At time of diagnosis</th><th class="td" title="table-head  " colspan="3" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">3 months after prescription</th></tr><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Compliant &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>45&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Non-compliant &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>62&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">p</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Compliant &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>45&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Non-compliant &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>62&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">p</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " colspan="7" align="left" valign="top"><span class="elsevierStyleItalic">TBS&#44; n &#40;&#37;&#41;</span></td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Greatly improved&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">9 &#40;20&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">17 &#40;27&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;743&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Improved&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">24 &#40;53&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">22 &#40;35&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>No change&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">12 &#40;26&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">23 &#40;37&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Worsened&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0 &#40;0&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0 &#40;0&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="7" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="7" align="left" valign="top"><span class="elsevierStyleItalic">OAB-qSF score&#44; mean &#40;SD&#41;</span></td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">&#42;</span></a>Bother scale&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">56&#46;0 &#40;15&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">53&#46;1 &#40;18&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;397&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">34&#46;9 &#40;22&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">34&#46;5 &#40;20&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;934&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">&#42;</span></a>Quality of life scale&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">62&#46;6 &#40;20&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">63&#46;4 &#40;20&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;870&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">75&#46;5 &#40;16&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">75&#46;9 &#40;18&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;693&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="7" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">&#42;</span></a><span class="elsevierStyleItalic">ICIQ-SF</span>&#44; mean score &#40;SD&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">13&#46;3 &#40;4&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">12&#46;7 &#40;4&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;685&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">9&#46;33 &#40;5&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">9&#46;79 &#40;5&#46;42&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;604&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
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            0 => array:3 [
              "identificador" => "tblfn0005"
              "etiqueta" => "&#42;"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0005"><span class="elsevierStyleItalic">p</span> intra-group at time of diagnosis vs&#46; months after prescription &#60;0&#46;0001&#46;</p>"
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">Patient-reported outcomes&#46;</p>"
        ]
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0005"
          "bibliografiaReferencia" => array:34 [
            0 => array:3 [
              "identificador" => "bib0175"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The standardisation of terminology of lower urinary tract function&#58; report from the standardisation sub-committee of the International Continence Society"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "P&#46; Abrams"
                            1 => "L&#46; Cardozo"
                            2 => "M&#46; Fall"
                            3 => "D&#46; Griffiths"
                            4 => "P&#46; Rosier"
                            5 => "U&#46; Ulmsten"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Neurourol Urodyn"
                        "fecha" => "2002"
                        "volumen" => "21"
                        "paginaInicial" => "167"
                        "paginaFinal" => "178"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11857671"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0180"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "&#91;Prevalence of urinary incontinence and hyperactive bladder in the Spanish population&#58; results of the EPICC study&#93;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "A&#46;E&#46; Martinez"
                            1 => "J&#46;L&#46; Ruiz Cerda"
                            2 => "P&#46;L&#46; Gomez"
                            3 => "B&#46;M&#46; Ramirez"
                            4 => "O&#46;F&#46; Delgado"
                            5 => "P&#46; Rebollo"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Actas Urol Esp"
                        "fecha" => "2009"
                        "volumen" => "33"
                        "paginaInicial" => "159"
                        "paginaFinal" => "166"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19418840"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0185"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Assessment of female prevalence of overactive bladder &#40;OAB&#41; in Barcelona using a self-administered screening questionnaire&#58; the cuestionario de autoevaluacion del control de la vejiga &#40;CACV&#41;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "S&#46;F&#46; Lugo"
                            1 => "B&#46;R&#46; Sanchez"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s00192-013-2067-1"
                      "Revista" => array:6 [
                        "tituloSerie" => "Int Urogynecol J"
                        "fecha" => "2013"
                        "volumen" => "24"
                        "paginaInicial" => "1559"
                        "paginaFinal" => "1566"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23443344"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0190"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The effect of urinary incontinence and overactive bladder symptoms on quality of life in young women"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "C&#46;H&#46; Van der Vaart"
                            1 => "J&#46;R&#46; de Leeuw"
                            2 => "J&#46;P&#46; Roovers"
                            3 => "A&#46;P&#46; Heintz"
                          ]
                        ]
                      ]
                    ]
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Article information

ISSN: 21735786
Original language: English

DOI:10.1016/j.acuroe.2015.03.005

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2018 March	1	0	1
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2017 May	14	2	16
2017 April	1	0	1
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2016 August	0	3	3
2016 July	0	1	1
2016 June	0	4	4
2016 May	0	10	10
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