SUCCESSFUL MANAGEMENT OF OVERACTIVE BLADDER (OAB) IS CRITICAL IN THE LONG-TERM CARE (LTC) SETTING

Urinary incontinence (UI) may be a symptom of a medical condition called OAB and may affect about 70% of LTC residents in the US1,2

  • From a survey* of 71 directors of nursing (DONs), of LTC residents who suffer from UI, 75% are either always or frequently incontinent3
  • According to the same survey, only ~15% of residents received any treatment for UI3
  • Up to 78% of women and up to 72% of men in LTC facilities live with UI, but OAB is not often diagnosed4†

*Based on a study of 71 DONs who completed a 30-minute online survey conducted from February 27, 2020 to May 11, 2020.3

†Cross-sectional retrospective analysis of 175,632 nursing facility residents from October 1, 2010 to September 30, 2012.4

Early identification and diagnosis may help residents affected by burdensome OAB symptoms3,5,6

Symptom recognition is a critical first step toward OAB care. As many residents suffer from cognitive decline, they may have difficulty reporting OAB symptoms.‡ Here’s what to look for2,7,8:

  • Urgency (the hallmark symptom) Sudden, strong urge to urinate immediately

  • Urge urinary incontinence (UUI)/leakage Involuntary leakage episodes (which may require use of absorbent products)

  • Frequency Urinating 8+ times per day

Only 7% of patients (n=10,911) with OAB are diagnosed and treated in the LTC setting9§

‡All data were obtained from the public use files of the 2010 National Survey of Residential Care Facilities (NSRCF) based on staff interviews in approximately 2300 assisted living residences.7

§From an IQVIA database reporting baseline characteristics of 159,785 LTC patients with OAB.

Many of your residents with OAB may benefit from treatment10

The following considerations may help you identify a resident who may be struggling with untreated OAB and could benefit from treatment:

  • Has been diagnosed with OAB (ICD-10-CM code N32.81||)11
  • Consistently expresses the need to urgently urinate2
  • Has had a “triggering event” (such as a fall, UTI, or complaint regarding UI)12-14
  • Rated incontinent based on the MDS 3.0 assessment15¶
  • Has been using or is scheduled to use absorbent products regularly16
  • Currently uses (or has previously used) an OAB medication that is not (or was not) achieving treatment goals2

||The ICD-10 code is the standard diagnostic tool for epidemiology, health management, and clinical purposes. Nothing in this document is intended to serve as reimbursement advice. The decision about which code to report must be made by the provider/physician considering the clinical facts, circumstances, and applicable coding rules.

MDS 3.0 is a resident assessment and care screening criteria for nursing homes.15

ICD=International Classification of Diseases; MDS=minimum data set; UTI=urinary tract infection.

Schedule a visit with a GEMTESA representative to learn more about how GEMTESA (vibegron) may help in the LTC setting

Request an LTC Rep

After choosing a medication, insurance coverage or affordability may affect your residents' access

LTC access & resources
 

References: 1. McDaniel C, Ratnani I, Fatima S, Abid MH, Surani S. Urinary incontinence in older adults takes collaborative nursing efforts to improve. Cureus. 2020;12(7):e9161. doi:10.7759/cureus.9161 2. Gormley EA, Lightner DJ, Burgio KL, et al. Diagnosis and treatment of overactive bladder (non-neurogenic) in adults: AUA/SUFU guideline. American Urological Association/Society of Urodynamics, Female Pelvic Medicine & Urogenital Reconstruction; 2019. Accessed July 20, 2021. https://www.auanet.org//guidelines-and-quality/guidelines/overactive-bladder-(oab)-guideline 3. Stefanacci RG, Yeaw J, Shah D, et al. Impact of urinary incontinence related to overactive bladder on long-term care residents and facilities: a perspective from directors of nursing. J Gerontol Nurs. 2022;48(7):38-46. doi:10.3928/00989134-20220606-06 4. Zarowitz BJ, Allen C, O’Shea T, Tangalos E, Berner T, Ouslander JG. Clinical burden and nonpharmacologic management of nursing facility residents with overactive bladder and/or urinary incontinence. Consult Pharm. 2015;30(9):533-542. doi:10.4140/TCP.n.2015.533 5. Lukacz ES, Sampselle C, Gray M, et al. A healthy bladder: a consensus statement. Int J Clin Pract. 2011;65(10):1026-1036. doi:10.1111/j.1742-1241.2011.02763.x 6. Aharony L, De Cock J, Nuotio MS, et al. Consensus document on the detection and diagnosis of urinary incontinence in older people. European Geriatric Medicine. 2017;8(3):202-209. doi.org/10.1016/j.eurger.2017.03.012 7. Zimmerman S, Sloane PD, Reed D. Dementia prevalence and care in assisted living. Health Aff (Millwood). 2014;33(4):658-666. doi:10.1377/hlthaff.2013.1255 8. Edmondson SD, Zhu C, Kar NF, et al. Discovery of vibegron: a potent and selective β3 adrenergic receptor agonist for the treatment of overactive bladder. J Med Chem. 2016;59(2):609-623. doi:10.1021/acs.jmedchem.5b01372 9. Data on file. Sumitomo Pharma America, Inc. 10. Willis-Gray MG, Dieter AA, Geller EJ. Evaluation and management of overactive bladder: strategies for optimizing care. Res Rep Urol. 2016;8:113-122. doi:10.2147/RRU.S93636 11. ICD-10 Index. Accessed February 11, 2021. https://icdlist.com/icd-10/index/other-diseases-of-the-urinary-system-n30-n39 12. Jayadevappa R, Chhatre S, Newman DK, Schwartz JS, Wein AJ. Association between overactive bladder treatment and falls among older adults. Neurourol Urodyn. 2018;37(8):2688-2694. doi:10.1002/nau.23719 13. Szabo SM, Gooch KL, Walker DR, Johnston KM, Wagg AS. The association between overactive bladder and falls and fractures: a systematic review. Adv Ther. 2018;35(11):1831-1841. doi:10.1007/s12325-018-0796-8 14. Perk S, Wielage RC, Campbell NL, et al. Estimated budget impact of increased use of mirabegron, a novel treatment for overactive bladder. J Manag Care Spec Pharm. 2016;22(9):1072-1084. doi:10.18553/jmcp.2016.22.9.1072 15. Department of Health and Human Services (DHHS), Centers for Medicare & Medicaid Services (CMS). MDS 3.0 Frequency Report. Accessed January 29, 2021. https://www.cms.gov/Research-Statistics-Data-and-Systems/Computer-Data-and-Systems/Minimum-Data-Set-3-0-Public-Reports 16. Freeman R, Foley S, Rosa Arias J, et al. Mirabegron improves quality-of-life, treatment satisfaction, and persistence in patients with overactive bladder: a multi-center, non-interventional, real-world, 12-month study. Curr Med Res Opin. 2018;34(5):785-793. doi:10.1080/03007995.2017.1419170

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