Examining Symptom Management and Quality of Life of Loop Diuretic-Induced Overactive Bladder Among Heart Failure Patients: Physician and Patient Perspectives.

Abstract

Loop diuretics are strongly recommended in patients with chronic congestive heart failure (HF) to alleviate signs and symptoms of fluid overload. Loop diuretics help relieve congestive symptoms and reduce mortality, but may have side effects. This survey study examined the impact of loop diuretic-induced overactive bladder (LD-OAB) symptoms on quality of life (QOL) in HF patients; and management of OAB by HF patients and physicians. We found that (1) HF patients noted less severity of symptoms but similar QOL with non-HF. (2) HF patients (58.8%) self-managed and underreported symptoms to physicians compared to non-HF (74.8%); accordingly 65% of physicians noticed and managed symptoms. (3) Patients used mechanical solutions (pads/diapers, Kegel exercises, and fluid reduction), and physicians adjusted diuretic doses or prescribed medications for OAB. Our study highlighted that HF patients' QOL associated with bladder symptoms was not better than the non-HF group despite milder symptoms. Many HF patients either did not report or coped with/self-managed their loop diuretic-induced bladder symptoms, pointing to a need for better awareness of patient experiences and patient-physician communication.