How can we explain the poor medication adherence in patients with overactive bladder syndrome?

The etiology of OAB is multifactorial and is associated with a large variation in symptom severity. This is reflected in variable pharmaceutical efficacy, which is widely studied for different neurogenic and non-neurogenic indications. Patient adherence to oral drug therapy of OAB is poor and in this paper several reasons for low patient adherence to OAB medication is discussed. Patients' mental health and cognitive impairment are to be considered as important factors, whereas the role of BMI, age, race and gender in patient drug adherence for OAB are uncertain. The two main reasons discussed in the literature for the discontinuation of OAB drugs are side effects and lack of efficiency. To reduce the discontinuation rate of anticholinergic therapy, patient education and a combination of anticholinergics in reduced dosage and mirabegron could be considered leading to a lower side effect incidence and a better efficacy. Development of an expectation modification tool for OAB could significantly improve adherence and therapy satisfaction and should be prioritized.