Pd43-11 Sociodemographic Factors and Frailty Impact Advanced Therapy Utilization Among Medicare Beneficiaries

You have accessJournal of UrologyUrodynamics/Lower Urinary Tract Dysfunction/Female Pelvic Medicine: Overactive Bladder I (PD43)1 May 2024PD43-11 SOCIODEMOGRAPHIC FACTORS AND FRAILTY IMPACT ADVANCED THERAPY UTILIZATION AMONG MEDICARE BENEFICIARIES Hodan Mohamud, Ekene A. Enemchukwu, Amy Zhang, Meredith West, Jennifer Anger, and Charles Scales Hodan MohamudHodan Mohamud , Ekene A. EnemchukwuEkene A. Enemchukwu , Amy ZhangAmy Zhang , Meredith WestMeredith West , Jennifer AngerJennifer Anger , and Charles ScalesCharles Scales View All Author Informationhttps://doi.org/10.1097/01.JU.0001009568.19060.25.11AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Overactive bladder (OAB) is a chronic condition the prevalence of which increases with age. Frailty is a clinical syndrome associated with age and is increasingly recognized as a stronger determinant of health status and outcomes. Increasing frailty and age are associated with OAB. Given the chronicity and overall impact of OAB on quality of life, multiple therapy options have been developed. This study aims to evaluate the impact of frailty and sociodemographic factors on OAB advanced therapy utilization among Medicare Beneficiaries. METHODS: Utilizing CMS 20% Research Identifiable File data, Medicare beneficiaries ≥65 years old with a diagnosis of OAB between 2013-2018 were identified and evaluated. Sociodemographic data was collected. Beneficiaries were then stratified using the Claims-Based Frailty Index (CFI) into 3 categories: not frail (CFI<0.15), prefrail (0.15≤CFI<0.25), and frail (CFI>0.25). CPT codes for OnabotulinumtoxinA (BTX-A), percutaneous tibial nerve stimulation (PTNS) and sacral neuromodulation (SNM) were used to estimate OAB advanced therapy utilization in our population during the study period. Logistic regression models were used to assess the impact of frailty and sociodemographic status on each advanced therapy use. RESULTS: A total of 171,196 patients (13.4% of the overall cohort) were treated for OAB during the study period, of whom 72% were women, 83% were White and 11.7% were frail. Overall, 9.6% of the population was treated with advanced therapies. On multivariate analysis, pre-frail/frail (OR 0.87), advancing age (HR 0.76), Black race (OR 0.7), and dual-eligible status (HR 0.37) patients were less likely to undergo any advanced therapy. Each individual advanced therapy was subsequently analyzed. Although frail patients were less likely to undergo PTNS, interestingly, frailty status was not associated with the likelihood of undergoing onabotulinumtoxinA or SNM. However, the lower likelihood of undergoing each individual advanced therapy remained for Black race and dual eligible status. CONCLUSIONS: Older age, frailty, race, and lower socioeconomic status were associated with a lower likelihood of undergoing any advanced therapy utilization during the study period. However, frailty wasn't associated with lower OnabotulinumtoxinA and SNM utilization. Source of Funding: NICHD R25 HD094667, NIH NIDDK K23 DK131315-01A1 © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e902 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Hodan Mohamud More articles by this author Ekene A. Enemchukwu More articles by this author Amy Zhang More articles by this author Meredith West More articles by this author Jennifer Anger More articles by this author Charles Scales More articles by this author Expand All Advertisement PDF downloadLoading ...