Drug utilization patterns and healthcare resource use and costs in patients with neurogenic bladder in the United Kingdom: A retrospective primary care database study.
Identifieur interne : 000269 ( Main/Exploration ); précédent : 000268; suivant : 000270Drug utilization patterns and healthcare resource use and costs in patients with neurogenic bladder in the United Kingdom: A retrospective primary care database study.
Auteurs : Ashley Jaggi [Royaume-Uni] ; Jameel Nazir [Royaume-Uni] ; Francis Fatoye [Royaume-Uni] ; Emad Siddiqui [Royaume-Uni] ; Nurul Choudhury [Royaume-Uni] ; Ramzi Argoubi [Tunisie] ; Mahmood Ali [Royaume-Uni] ; Dirk De Ridder [Belgique] ; Marcus J. Drake [Royaume-Uni]Source :
- Neurourology and urodynamics [ 1520-6777 ] ; 2019.
Descripteurs français
- KwdFr :
- Acceptation des soins par les patients (statistiques et données numériques), Adulte (MeSH), Adulte d'âge moyen (MeSH), Antagonistes cholinergiques (usage thérapeutique), Bases de données factuelles (MeSH), Femelle (MeSH), Humains (MeSH), Incontinence urinaire (complications), Incontinence urinaire (épidémiologie), Infections urinaires (complications), Infections urinaires (épidémiologie), Mâle (MeSH), Royaume-Uni (épidémiologie), Soins de santé primaires (statistiques et données numériques), Soins de santé primaires (économie), Sujet âgé (MeSH), Sujet âgé de 80 ans ou plus (MeSH), Utilisation médicament (statistiques et données numériques), Vessie neurologique (traitement médicamenteux), Vessie neurologique (économie), Vessie neurologique (épidémiologie), Études rétrospectives (MeSH).
- MESH :
- statistiques et données numériques : Acceptation des soins par les patients, Soins de santé primaires, Utilisation médicament.
- traitement médicamenteux : Vessie neurologique.
- usage thérapeutique : Antagonistes cholinergiques, Incontinence urinaire, Infections urinaires.
- économie : Soins de santé primaires, Vessie neurologique.
- épidémiologie : Incontinence urinaire, Infections urinaires, Royaume-Uni, Vessie neurologique.
- Adulte, Adulte d'âge moyen, Bases de données factuelles, Femelle, Humains, Mâle, Sujet âgé, Sujet âgé de 80 ans ou plus, Études rétrospectives.
- Wicri :
- geographic : Royaume-Uni.
English descriptors
- KwdEn :
- Adult (MeSH), Aged (MeSH), Aged, 80 and over (MeSH), Cholinergic Antagonists (therapeutic use), Databases, Factual (MeSH), Drug Utilization (statistics & numerical data), Female (MeSH), Humans (MeSH), Male (MeSH), Middle Aged (MeSH), Patient Acceptance of Health Care (statistics & numerical data), Primary Health Care (economics), Primary Health Care (statistics & numerical data), Retrospective Studies (MeSH), United Kingdom (epidemiology), Urinary Bladder, Neurogenic (drug therapy), Urinary Bladder, Neurogenic (economics), Urinary Bladder, Neurogenic (epidemiology), Urinary Incontinence (complications), Urinary Incontinence (epidemiology), Urinary Tract Infections (complications), Urinary Tract Infections (epidemiology).
- MESH :
- chemical , therapeutic use : Cholinergic Antagonists.
- geographic , epidemiology : United Kingdom.
- complications : Urinary Incontinence, Urinary Tract Infections.
- drug therapy : Urinary Bladder, Neurogenic.
- economics : Primary Health Care, Urinary Bladder, Neurogenic.
- epidemiology : Urinary Bladder, Neurogenic, Urinary Incontinence, Urinary Tract Infections.
- statistics & numerical data : Drug Utilization, Patient Acceptance of Health Care, Primary Health Care.
- Adult, Aged, Aged, 80 and over, Databases, Factual, Female, Humans, Male, Middle Aged, Retrospective Studies.
Abstract
AIM
To characterize patients with neurogenic bladder (NGB), their treatment patterns, healthcare resource utilization, and associated costs based on records from a primary care database in the United Kingdom.
METHODS
This was a retrospective, descriptive, observational study of anonymized data from the Clinical Practice Research Datalink and Hospital Episode Statistics databases (selection period, 1 January 2004 to 31 December 2016). Adults with a definitive or probable diagnosis of NGB and ≥1 referral to a urologist were included.
RESULTS
The study cohort included 3913 patients with definitive (n = 363) or probable (n = 3550) NGB. Patients had a mean of 8.6 (standard deviation [SD], 7.6) comorbidities, and mean Anticholinergic Cognitive Burden Scale score of 6.6 (SD, 5.9). During 12 months' follow-up, urinary tract infection (UTI) and urinary incontinence were the most common complications. Most patients (92.2%) received ≥1 prescription for an antimuscarinic agent or mirabegron, and 53.9% of patients received prescriptions for UTI-specific antibiotics. The mean number of visits to a general practitioner for any cause was 67.7 (SD, 42.6) per individual. Almost half (46.7%) of the study cohort visited a specialist during the 12-month follow-up period, and 11.0% had ≥1 hospital admission. Total mean per patient costs for healthcare resource utilization was £2395.
CONCLUSIONS
The burden of illness, healthcare resource needs, and associated costs among patients with NGB are considerable. Drug prescribing patterns are consistent with the symptoms and complications of NGB, although increased awareness of drugs with anticholinergic activity among prescribers may help to reduce the cumulative anticholinergic burden in this vulnerable population.
DOI: 10.1002/nau.23981
PubMed: 30924184
PubMed Central: PMC6850049
Affiliations:
- Belgique, Royaume-Uni, Tunisie
- Angleterre, Angleterre du Sud-Ouest, Grand Manchester
- Bristol (Royaume-Uni), Manchester
- Université de Bristol
Links toward previous steps (curation, corpus...)
Le document en format XML
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Kingdom.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Health Economics and Outcomes Research, Astellas Pharma Europe Ltd, Chertsey</wicri:regionArea><wicri:noRegion>Chertsey</wicri:noRegion></affiliation></author><author><name sortKey="Choudhury, Nurul" sort="Choudhury, Nurul" uniqKey="Choudhury N" first="Nurul" last="Choudhury">Nurul Choudhury</name><affiliation wicri:level="1"><nlm:affiliation>Health Economics and Outcomes Research, Astellas Pharma Europe Ltd, Chertsey, United Kingdom.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Health Economics and Outcomes Research, Astellas Pharma Europe Ltd, Chertsey</wicri:regionArea><wicri:noRegion>Chertsey</wicri:noRegion></affiliation></author><author><name sortKey="Argoubi, Ramzi" sort="Argoubi, Ramzi" uniqKey="Argoubi R" first="Ramzi" last="Argoubi">Ramzi Argoubi</name><affiliation wicri:level="1"><nlm:affiliation>Health Economics and Outcomes Research, Creativ-Ceutical SARL, Les Berges du lac, Tunisia.</nlm:affiliation><country xml:lang="fr">Tunisie</country><wicri:regionArea>Health Economics and Outcomes Research, Creativ-Ceutical SARL, Les Berges du lac</wicri:regionArea><wicri:noRegion>Les Berges du lac</wicri:noRegion></affiliation></author><author><name sortKey="Ali, Mahmood" sort="Ali, Mahmood" uniqKey="Ali M" first="Mahmood" last="Ali">Mahmood Ali</name><affiliation wicri:level="3"><nlm:affiliation>Department of Health Professions, Manchester Metropolitan University, Manchester, United Kingdom.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Department of Health Professions, Manchester Metropolitan University, Manchester</wicri:regionArea><placeName><settlement type="city">Manchester</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Manchester</region></placeName></affiliation><affiliation wicri:level="1"><nlm:affiliation>Health Economics and Outcomes Research, Astellas Pharma Europe Ltd, Chertsey, United Kingdom.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Health Economics and Outcomes Research, Astellas Pharma Europe Ltd, Chertsey</wicri:regionArea><wicri:noRegion>Chertsey</wicri:noRegion></affiliation></author><author><name sortKey="De Ridder, Dirk" sort="De Ridder, Dirk" uniqKey="De Ridder D" first="Dirk" last="De Ridder">Dirk De Ridder</name><affiliation wicri:level="1"><nlm:affiliation>Department of Urology, Organ Systems, Development and Regeneration, University of Leuven, Leuven, Belgium.</nlm:affiliation><country xml:lang="fr">Belgique</country><wicri:regionArea>Department of Urology, Organ Systems, Development and Regeneration, University of Leuven, Leuven</wicri:regionArea><wicri:noRegion>Leuven</wicri:noRegion></affiliation></author><author><name sortKey="Drake, Marcus J" sort="Drake, Marcus J" uniqKey="Drake M" first="Marcus J" last="Drake">Marcus J. Drake</name><affiliation wicri:level="4"><nlm:affiliation>School of Clinical Sciences, Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>School of Clinical Sciences, Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol</wicri:regionArea><orgName type="university">Université de Bristol</orgName><placeName><settlement type="city">Bristol (Royaume-Uni)</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Angleterre du Sud-Ouest</region></placeName></affiliation></author></analytic><series><title level="j">Neurourology and urodynamics</title><idno type="eISSN">1520-6777</idno><imprint><date when="2019" type="published">2019</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adult (MeSH)</term><term>Aged (MeSH)</term><term>Aged, 80 and over (MeSH)</term><term>Cholinergic Antagonists (therapeutic use)</term><term>Databases, Factual (MeSH)</term><term>Drug Utilization (statistics & numerical data)</term><term>Female (MeSH)</term><term>Humans (MeSH)</term><term>Male (MeSH)</term><term>Middle Aged (MeSH)</term><term>Patient Acceptance of Health Care (statistics & numerical data)</term><term>Primary Health Care (economics)</term><term>Primary Health Care (statistics & numerical data)</term><term>Retrospective Studies (MeSH)</term><term>United Kingdom (epidemiology)</term><term>Urinary Bladder, Neurogenic (drug therapy)</term><term>Urinary Bladder, Neurogenic (economics)</term><term>Urinary Bladder, Neurogenic (epidemiology)</term><term>Urinary Incontinence (complications)</term><term>Urinary Incontinence (epidemiology)</term><term>Urinary Tract Infections (complications)</term><term>Urinary Tract Infections (epidemiology)</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Acceptation des soins par les patients (statistiques et données numériques)</term><term>Adulte (MeSH)</term><term>Adulte d'âge moyen (MeSH)</term><term>Antagonistes cholinergiques (usage thérapeutique)</term><term>Bases de données factuelles (MeSH)</term><term>Femelle (MeSH)</term><term>Humains (MeSH)</term><term>Incontinence urinaire (complications)</term><term>Incontinence urinaire (épidémiologie)</term><term>Infections urinaires (complications)</term><term>Infections urinaires (épidémiologie)</term><term>Mâle (MeSH)</term><term>Royaume-Uni (épidémiologie)</term><term>Soins de santé primaires (statistiques et données numériques)</term><term>Soins de santé primaires (économie)</term><term>Sujet âgé (MeSH)</term><term>Sujet âgé de 80 ans ou plus (MeSH)</term><term>Utilisation médicament (statistiques et données numériques)</term><term>Vessie neurologique (traitement médicamenteux)</term><term>Vessie neurologique (économie)</term><term>Vessie neurologique (épidémiologie)</term><term>Études rétrospectives (MeSH)</term></keywords><keywords scheme="MESH" type="chemical" qualifier="therapeutic use" xml:lang="en"><term>Cholinergic Antagonists</term></keywords><keywords scheme="MESH" type="geographic" qualifier="epidemiology" xml:lang="en"><term>United Kingdom</term></keywords><keywords scheme="MESH" qualifier="complications" xml:lang="en"><term>Urinary Incontinence</term><term>Urinary Tract Infections</term></keywords><keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>Urinary Bladder, Neurogenic</term></keywords><keywords scheme="MESH" qualifier="economics" xml:lang="en"><term>Primary Health Care</term><term>Urinary Bladder, Neurogenic</term></keywords><keywords scheme="MESH" qualifier="epidemiology" xml:lang="en"><term>Urinary Bladder, Neurogenic</term><term>Urinary Incontinence</term><term>Urinary Tract Infections</term></keywords><keywords scheme="MESH" qualifier="statistics & numerical data" xml:lang="en"><term>Drug Utilization</term><term>Patient Acceptance of Health Care</term><term>Primary Health Care</term></keywords><keywords scheme="MESH" qualifier="statistiques et données numériques" xml:lang="fr"><term>Acceptation des soins par les patients</term><term>Soins de santé primaires</term><term>Utilisation médicament</term></keywords><keywords scheme="MESH" qualifier="traitement médicamenteux" xml:lang="fr"><term>Vessie neurologique</term></keywords><keywords scheme="MESH" qualifier="usage thérapeutique" xml:lang="fr"><term>Antagonistes cholinergiques</term><term>Incontinence urinaire</term><term>Infections urinaires</term></keywords><keywords scheme="MESH" qualifier="économie" xml:lang="fr"><term>Soins de santé primaires</term><term>Vessie neurologique</term></keywords><keywords scheme="MESH" qualifier="épidémiologie" xml:lang="fr"><term>Incontinence urinaire</term><term>Infections urinaires</term><term>Royaume-Uni</term><term>Vessie neurologique</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adult</term><term>Aged</term><term>Aged, 80 and over</term><term>Databases, Factual</term><term>Female</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Retrospective Studies</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Adulte</term><term>Adulte d'âge moyen</term><term>Bases de données factuelles</term><term>Femelle</term><term>Humains</term><term>Mâle</term><term>Sujet âgé</term><term>Sujet âgé de 80 ans ou plus</term><term>Études rétrospectives</term></keywords><keywords scheme="Wicri" type="geographic" xml:lang="fr"><term>Royaume-Uni</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><b>AIM</b></p><p>To characterize patients with neurogenic bladder (NGB), their treatment patterns, healthcare resource utilization, and associated costs based on records from a primary care database in the United Kingdom.</p></div><div type="abstract" xml:lang="en"><p><b>METHODS</b></p><p>This was a retrospective, descriptive, observational study of anonymized data from the Clinical Practice Research Datalink and Hospital Episode Statistics databases (selection period, 1 January 2004 to 31 December 2016). Adults with a definitive or probable diagnosis of NGB and ≥1 referral to a urologist were included.</p></div><div type="abstract" xml:lang="en"><p><b>RESULTS</b></p><p>The study cohort included 3913 patients with definitive (n = 363) or probable (n = 3550) NGB. Patients had a mean of 8.6 (standard deviation [SD], 7.6) comorbidities, and mean Anticholinergic Cognitive Burden Scale score of 6.6 (SD, 5.9). During 12 months' follow-up, urinary tract infection (UTI) and urinary incontinence were the most common complications. Most patients (92.2%) received ≥1 prescription for an antimuscarinic agent or mirabegron, and 53.9% of patients received prescriptions for UTI-specific antibiotics. The mean number of visits to a general practitioner for any cause was 67.7 (SD, 42.6) per individual. Almost half (46.7%) of the study cohort visited a specialist during the 12-month follow-up period, and 11.0% had ≥1 hospital admission. Total mean per patient costs for healthcare resource utilization was £2395.</p></div><div type="abstract" xml:lang="en"><p><b>CONCLUSIONS</b></p><p>The burden of illness, healthcare resource needs, and associated costs among patients with NGB are considerable. Drug prescribing patterns are consistent with the symptoms and complications of NGB, although increased awareness of drugs with anticholinergic activity among prescribers may help to reduce the cumulative anticholinergic burden in this vulnerable population.</p></div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" IndexingMethod="Curated" Owner="NLM"><PMID Version="1">30924184</PMID><DateCompleted><Year>2020</Year><Month>04</Month><Day>13</Day></DateCompleted><DateRevised><Year>2021</Year><Month>01</Month><Day>09</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1520-6777</ISSN><JournalIssue CitedMedium="Internet"><Volume>38</Volume><Issue>5</Issue><PubDate><Year>2019</Year><Month>06</Month></PubDate></JournalIssue><Title>Neurourology and urodynamics</Title><ISOAbbreviation>Neurourol Urodyn</ISOAbbreviation></Journal><ArticleTitle>Drug utilization patterns and healthcare resource use and costs in patients with neurogenic bladder in the United Kingdom: A retrospective primary care database study.</ArticleTitle><Pagination><MedlinePgn>1278-1289</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1002/nau.23981</ELocationID><Abstract><AbstractText Label="AIM">To characterize patients with neurogenic bladder (NGB), their treatment patterns, healthcare resource utilization, and associated costs based on records from a primary care database in the United Kingdom.</AbstractText><AbstractText Label="METHODS">This was a retrospective, descriptive, observational study of anonymized data from the Clinical Practice Research Datalink and Hospital Episode Statistics databases (selection period, 1 January 2004 to 31 December 2016). Adults with a definitive or probable diagnosis of NGB and ≥1 referral to a urologist were included.</AbstractText><AbstractText Label="RESULTS">The study cohort included 3913 patients with definitive (n = 363) or probable (n = 3550) NGB. Patients had a mean of 8.6 (standard deviation [SD], 7.6) comorbidities, and mean Anticholinergic Cognitive Burden Scale score of 6.6 (SD, 5.9). During 12 months' follow-up, urinary tract infection (UTI) and urinary incontinence were the most common complications. Most patients (92.2%) received ≥1 prescription for an antimuscarinic agent or mirabegron, and 53.9% of patients received prescriptions for UTI-specific antibiotics. The mean number of visits to a general practitioner for any cause was 67.7 (SD, 42.6) per individual. Almost half (46.7%) of the study cohort visited a specialist during the 12-month follow-up period, and 11.0% had ≥1 hospital admission. Total mean per patient costs for healthcare resource utilization was £2395.</AbstractText><AbstractText Label="CONCLUSIONS">The burden of illness, healthcare resource needs, and associated costs among patients with NGB are considerable. Drug prescribing patterns are consistent with the symptoms and complications of NGB, although increased awareness of drugs with anticholinergic activity among prescribers may help to reduce the cumulative anticholinergic burden in this vulnerable population.</AbstractText><CopyrightInformation>© 2019 The Authors. Neurourology and Urodynamics Published by Wiley Periodicals, Inc.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Jaggi</LastName><ForeName>Ashley</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>Department of Health Professions, Manchester Metropolitan University, Manchester, United Kingdom.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Health Economics and Outcomes Research, Astellas Pharma Europe Ltd, Chertsey, United Kingdom.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Nazir</LastName><ForeName>Jameel</ForeName><Initials>J</Initials><AffiliationInfo><Affiliation>Health Economics and Outcomes Research, Astellas Pharma Europe Ltd, Chertsey, United Kingdom.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Fatoye</LastName><ForeName>Francis</ForeName><Initials>F</Initials><AffiliationInfo><Affiliation>Department of Health Professions, Manchester Metropolitan University, Manchester, United Kingdom.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Siddiqui</LastName><ForeName>Emad</ForeName><Initials>E</Initials><AffiliationInfo><Affiliation>Health Economics and Outcomes Research, Astellas Pharma Europe Ltd, Chertsey, United Kingdom.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Choudhury</LastName><ForeName>Nurul</ForeName><Initials>N</Initials><AffiliationInfo><Affiliation>Health Economics and Outcomes Research, Astellas Pharma Europe Ltd, Chertsey, United Kingdom.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Argoubi</LastName><ForeName>Ramzi</ForeName><Initials>R</Initials><AffiliationInfo><Affiliation>Health Economics and Outcomes Research, Creativ-Ceutical SARL, Les Berges du lac, Tunisia.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Ali</LastName><ForeName>Mahmood</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Department of Health Professions, Manchester Metropolitan University, Manchester, United Kingdom.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Health Economics and Outcomes Research, Astellas Pharma Europe Ltd, Chertsey, United Kingdom.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>de Ridder</LastName><ForeName>Dirk</ForeName><Initials>D</Initials><Identifier Source="ORCID">0000-0001-6914-0077</Identifier><AffiliationInfo><Affiliation>Department of Urology, Organ Systems, Development and Regeneration, University of Leuven, Leuven, Belgium.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Drake</LastName><ForeName>Marcus J</ForeName><Initials>MJ</Initials><Identifier Source="ORCID">0000-0002-6230-2552</Identifier><AffiliationInfo><Affiliation>School of Clinical Sciences, Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D013485">Research Support, Non-U.S. Gov't</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2019</Year><Month>03</Month><Day>28</Day></ArticleDate></Article><MedlineJournalInfo><Country>United States</Country><MedlineTA>Neurourol Urodyn</MedlineTA><NlmUniqueID>8303326</NlmUniqueID><ISSNLinking>0733-2467</ISSNLinking></MedlineJournalInfo><ChemicalList><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D018680">Cholinergic Antagonists</NameOfSubstance></Chemical></ChemicalList><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D000328" MajorTopicYN="N">Adult</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000368" MajorTopicYN="N">Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000369" MajorTopicYN="N">Aged, 80 and over</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D018680" MajorTopicYN="N">Cholinergic Antagonists</DescriptorName><QualifierName UI="Q000627" MajorTopicYN="N">therapeutic use</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D016208" MajorTopicYN="N">Databases, Factual</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D004363" MajorTopicYN="N">Drug Utilization</DescriptorName><QualifierName UI="Q000706" MajorTopicYN="Y">statistics & numerical data</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008875" MajorTopicYN="N">Middle Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D010342" MajorTopicYN="N">Patient Acceptance of Health Care</DescriptorName><QualifierName UI="Q000706" MajorTopicYN="Y">statistics & numerical data</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D011320" MajorTopicYN="N">Primary Health Care</DescriptorName><QualifierName UI="Q000191" MajorTopicYN="N">economics</QualifierName><QualifierName UI="Q000706" MajorTopicYN="N">statistics & numerical data</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D012189" MajorTopicYN="N">Retrospective Studies</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006113" MajorTopicYN="N" Type="Geographic">United Kingdom</DescriptorName><QualifierName UI="Q000453" MajorTopicYN="N">epidemiology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D001750" MajorTopicYN="N">Urinary Bladder, Neurogenic</DescriptorName><QualifierName UI="Q000188" MajorTopicYN="Y">drug therapy</QualifierName><QualifierName UI="Q000191" MajorTopicYN="Y">economics</QualifierName><QualifierName UI="Q000453" MajorTopicYN="N">epidemiology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D014549" MajorTopicYN="N">Urinary Incontinence</DescriptorName><QualifierName UI="Q000150" MajorTopicYN="N">complications</QualifierName><QualifierName UI="Q000453" MajorTopicYN="N">epidemiology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D014552" MajorTopicYN="N">Urinary Tract Infections</DescriptorName><QualifierName UI="Q000150" MajorTopicYN="N">complications</QualifierName><QualifierName UI="Q000453" MajorTopicYN="N">epidemiology</QualifierName></MeshHeading></MeshHeadingList><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="Y">cholinergic antagonists</Keyword><Keyword MajorTopicYN="Y">comorbidity</Keyword><Keyword MajorTopicYN="Y">healthcare costs</Keyword><Keyword MajorTopicYN="Y">healthcare resources</Keyword><Keyword MajorTopicYN="Y">neurogenic</Keyword><Keyword MajorTopicYN="Y">retrospective studies</Keyword><Keyword MajorTopicYN="Y">urinary bladder</Keyword></KeywordList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2018</Year><Month>12</Month><Day>18</Day></PubMedPubDate><PubMedPubDate PubStatus="revised"><Year>2019</Year><Month>01</Month><Day>29</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2019</Year><Month>03</Month><Day>01</Day></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2019</Year><Month>3</Month><Day>30</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2020</Year><Month>4</Month><Day>14</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2019</Year><Month>3</Month><Day>30</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">30924184</ArticleId><ArticleId IdType="doi">10.1002/nau.23981</ArticleId><ArticleId 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