OBJECTIVES: This study described the prevalence, demographic and functional characteristics and treatment patterns of long-stay nursing home residents with Overactive Bladder (OAB).

METHODS: This retrospective longitudinal study used 2013-2015 Minimum Data Set linked Medicare data. The study consisted of long-stay nursing home residents (≥101 consecutive days of nursing home stay) aged 65 years and older with a diagnosis of OAB (based on ICD-9-CM or OAB-specific medications).OAB-specific medications included antimuscarinics, mirabegron, or onabotulinumtoxinA. Antimuscarinic medications included darifenacin, fesoterodine, oxybutynin, solifenacin, tolterodine, and trospium. Descriptive statistics was performed to describe patient characteristics and treatment patterns of long-stay nursing home residents with OAB.

RESULTS: The cohort included 1.2 million elderly long-stay nursing home residents; there were 451,351 OAB patients for an overall prevalence of 36.31%. The mean age of the OAB patients was 82.21 ± 8.32 years, and the cohort predominantly consisted of females (68.95%), non-Hispanic Whites (85.82%), and residents from an urban area (76.73%). Most prevalent comorbidities were hypertension (95.07%), fluid and electrolyte disorders (75.35%), and depression (67.75%). Antidepressants (73.08%), diuretics (60.81%), and beta-blockers (58.87%) were most commonly used medications. The mean Anticholinergic Burden (ACB) score for the cohort was 6.28 ± 4.22. The majority of patients had intact cognition scale (80.64%) and were dependent on Activities of Daily Living. Overall, 37.91% of the OAB patients used antimuscarinics; the most commonly prescribed antimuscarinics were oxybutynin (25.84%), solifenacin (9.14%), and tolterodine (7.34%).

CONCLUSIONS: Over a third of long-stay nursing home residents had OAB and 38% of these patients used antimuscarinic drugs, mainly oxybutynin. In light of the high ACB scores, concerted efforts are needed to optimize antimuscarinic use to improve quality of care of OAB in nursing homes.