米拉贝琼在治疗膀胱过度活动症中的作用:印度医疗保健专业人员的知识、态度和实践调查

Madhu Sudan Agrawal, Sanjay Pandey, Prem Kumar, Vikram Sahu, Dinesh Patil
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摘要

背景:膀胱过度活动症(OAB)表现为尿急,伴有或不伴有尿急尿失禁,通常伴有日间尿频和夜尿增多,且无感染或其他明显病变:2022年1月至2023年7月,在印度各地开展了一项横断面、观察性、基于问卷的知识、态度和实践(KAP)调查,通过与1 029名医疗保健专业人员(HCPs)(包括泌尿科医生、外科医生、肾科医生和会诊医生)分享问卷中的14个多选题来了解OAB疗法:医护人员在临床实践中每天接诊 10-20% 的患者,其中 5-10% 为女性。患者通常先看全科医生,然后再看其他专科医生。虽然抗胆碱能药物是治疗 OAB 的常用药物,但据 HCPs 报告,副作用(57%)和高昂的治疗费用(43%)是停用抗胆碱能药物的主要原因。在治疗这些患者时,67% 的保健医生首选米拉贝琼。在本次调查中,米拉贝琼也是所有保健医生首选的一线治疗药物。米拉贝琼的处方疗程为 6-12 个月,在临床实践中的反应率大于 75%,而且与抗胆碱能药物相比,米拉贝琼的副作用更小。如果患者对抗胆碱能药物无反应或治疗失败,则首选米拉贝琼和索利那新联合疗法:这项调查强调了米拉贝琼作为 OAB 一线治疗药物的用途、其较好的副作用以及与索利那新联合治疗对抗胆碱能药物无反应患者的作用,最终改善了患者的生活质量。
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Role of mirabegron in the management of overactive bladder: a knowledge, attitude, and practice survey among Indian healthcare professionals
Background: Overactive bladder (OAB) is identified by urinary urgency, with or without urgency urinary incontinence, typically accompanied by increased daytime urinary frequency and nocturia, in the absence of proven infection or other evident pathology. Methods: A cross-sectional, observational, questionnaire-based knowledge, attitude, and practice (KAP) survey was conducted across India from January 2022 to July 2023 to understand OAB therapy through 14 multiple–choice questions containing questionnaire shared with 1, 029 healthcare professionals (HCPs), including urologists, surgeons, nephrologists, and consulting physicians. Results: The HCPs see 10-20% of patients daily in clinical practice, wherein 5-10% are females. Patients usually consult general practitioners first and then other specialists. Although anticholinergics are commonly used in the management of OAB, HCPs reported that side effects (57%) and the high cost of therapy (43%) were mainly responsible for discontinuing anticholinergics. Mirabegron was preferred by 67% of HCPs in the treatment of these patients. Mirabegron is also preferred as a first-line treatment by all HCPs in this survey. It is prescribed for 6-12 months, has a response rate of >75% in clinical practice, and offers a more favourable side-effect profile compared to anticholinergics. In cases where patients do not respond to anticholinergics or experience treatment failure, a combination therapy of mirabegron and solifenacin is preferred. Conclusions: The survey highlights the use of mirabegron as a first-line treatment for OAB, its better side-effect profile, and its role in combination therapy with solifenacin for patients unresponsive to anticholinergics, ultimately improving the quality of life of patients.
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