Overactive Bladder Medication Prescribing Trends in the Era of Known Cognitive Effects from Anticholinergic Drugs

• Published in: Current bladder dysfunction reports 2023-09, Vol.18 (3), p.237-243
• Main Authors: Stern, Noah, Welk, Blayne
• Format: Article
• Language: English
• Subjects: Geriatrics/Gerontology; Gynecology; Medicine; Medicine & Public Health; Topical Collection on Overactive Bladder; Urology
• ISSN: 1931-7212; 1931-7220
• DOI: 10.1007/s11884-023-00705-7

Purpose of Review To review recent global trends in the prescribing of anticholinergic medications for overactive bladder (OAB) and the potential impact of cognitive side effect concerns on prescription patterns. Recent Findings The utilization of anticholinergic medications for OAB has been a topic of concern due to their potential to cause cognitive impairment and other adverse effects, particularly in older adults. Recent data suggests a global decrease in their use, potentially due to increased awareness of their cognitive risks among healthcare professionals. The decrease in OAB anticholinergic use has been facilitated by the availability of the new class of beta-3 agonist OAB medications. The current literature suggests that the use of these medications has increased in several countries. These prescribing trends may be primarily driven by specialists, though the quality of the data supporting this is relatively poor. Summary The prescribing of anticholinergic medications for OAB has undergone a significant shift in recent years, with increased awareness of their cognitive risks potentially driving a decrease in their use. However, barriers to reducing their use even further remain, including a lack of knowledge and understanding among healthcare providers and financial barriers to alternative treatments. Efforts to increase awareness and education around the risks associated with anticholinergics and address step-prescription requirements could help to further reduce their use and improve patient outcomes.