Do medication prescription patterns follow guidelines in a cohort of women with interstitial cystitis/bladder pain syndrome?

Details

• Alternative Title:
  Neurourol Urodyn
• Personal Author:
  Tholemeier, Lauren N ; Bresee, Catherine ; De Hoedt, Amanda M. ; Barbour, Kamil E. ; Kim, Jayoung ; Freedland, Stephen ; Anger, Jennifer T.
• Description:
  Objective:
  
  To describe prescription patterns for women with interstitial cystitis/bladder pain syndrome (IC/BPS) and to determine whether these patterns are aligned with treatment guidelines.
  
  Methods:
  
  We sampled female patients with an ICD-9/10 diagnosis of IC/BPS (595.1/N30.10) by querying active users of the Veterans Health Administration. Medical records were reviewed to determine whether patients met IC/BPS diagnostic criteria. A cohort of women with other pelvic pain disorders (“IC-like”) was identified. Prescription patterns were compared between the two cohorts. Prescription prevalence of typical bladder pain medications was compared before and after the diagnosis of IC/BPS was made using Poisson regression.
  
  Results:
  
  There were 641 women who met criteria for IC/BPS and 197 women with IC-like disorders. Women with IC/BPS were prescribed a pain medication more often than those with IC-like conditions (77% versus 59%, p<0.0001). Of the women with IC/BPS, 44% tried 3 or more pain medications. Of women with a diagnosis of IC/BPS, only 67% were prescribed an AUA-recommended medication. Prescription incidence increased after diagnosis for both pentosan polysulfate (10% to 29%, p<0.0001) and hydroxyzine (17% to 40%, p<0.0001), but not for amitriptyline or cimetidine. Amitriptyline was prescribed to 223 women with IC/BPS, only 125 of which (56%) had a documented history of depression.
  
  Conclusions:
  
  Many women with IC/BPS required multiple bladder prescriptions, highlighting the difficulty in finding an effective treatment for IC/BPS. PPS and hydroxyzine were preferred IC/BPS medications. Our next step will be to analyze treatment patterns in those patients who did not receive medications.
  
  
• Keywords:
  Amitriptyline Bladder Pain Syndrome Chronic Pain Cystitis, Interstitial Drug Prescriptions Female Humans Hydroxyzine Interstitial Cystitis Pelvic Pain Pentosan Polysulfate Pentosan Sulfuric Polyester

  More +
• Source:
  Neurourol Urodyn. 41(5):1121-1126
• Pubmed ID:
  35391498
• Pubmed Central ID:
  PMC10460127
• Document Type:
  Journal Article
• Funding:
  U01 DP006079/DP/NCCDPHP CDC HHSUnited States/ ; U01DP006079/ACL/ACL HHSUnited States/
• Volume:
  41
• Issue:
  5
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:c48f1d562aff90a6c36fb1fe259cbe0f72836dd065665a91bfa3203202a05087
• Download URL:
  https://stacks.cdc.gov/view/cdc/132373/cdc_132373_DS1.pdf
• File Type:
  [PDF - 78.50 KB ]