Real-world Compliance With Percutaneous Tibial Nerve Stimulation Maintenance Therapy in an American Population

To evaluate percutaneous tibial nerve stimulation (PTNS) maintenance therapy dropout rates and identify factors associated with compliance in an American population. We retrospectively queried our PTNS database for patients from 2014-2019. Demographic, relevant clinical, and visit data were collecte...

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Published in:Urology (Ridgewood, N.J.) N.J.), 2021-07, Vol.153, p.119-123
Main Authors: Du, Chris, Berg, William, Siegal, Alexandra R., Huang, Zhenyue, Jeong, Rosen, Hwang, Kuemin, Kim, Jason
Format: Article
Language:English
Subjects:
Continuity of Patient Care - standards
Continuity of Patient Care - statistics & numerical data
Female
Humans
Male
Middle Aged
Needs Assessment
Patient Compliance - psychology
Patient Compliance - statistics & numerical data
Patient Dropouts - statistics & numerical data
Symptom Assessment - methods
Tibial Nerve
Transcutaneous Electric Nerve Stimulation - methods
Transcutaneous Electric Nerve Stimulation - statistics & numerical data
Treatment Outcome
United States - epidemiology
Urinary Bladder, Overactive - diagnosis
Urinary Bladder, Overactive - epidemiology
Urinary Bladder, Overactive - psychology
Urinary Bladder, Overactive - therapy
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Summary:To evaluate percutaneous tibial nerve stimulation (PTNS) maintenance therapy dropout rates and identify factors associated with compliance in an American population. We retrospectively queried our PTNS database for patients from 2014-2019. Demographic, relevant clinical, and visit data were collected. Maintenance therapy was patient-driven and frequency of sessions was tapered based on symptomology. Upon completion of 12 initial sessions, we assessed dropout from maintenance at 3, 6, 9, and 12 months. Multiple variables were tested for correlation with dropout in patients continuing maintenance therapy for 1 year vs those who dropped out. One hundred and sixty-three PTNS patients were identified, of which 104 completed initial therapy and 81 proceeded with maintenance therapy. At 3, 6, 9, and 12 months, maintenance continuation rates were 77.8% (63/81), 58.0% (47/81), 45.6% (37/81), and 39.5% (32/41), respectively. Primary reasons for dropout were worsening of urinary symptoms/lack of efficacy (n = 21), time commitment (n = 9), loss of insurance (n = 5), medical comorbidities (n = 4), request for alternative OAB treatment (n = 2), and unknown (n = 8). On both univariate and multivariate analysis, perceived symptom improvement (P
ISSN:0090-4295
1527-9995
DOI:10.1016/j.urology.2021.02.005