Obstetrics & Gynaecology has published the results of an observational study into the discontinuation rates of anticholinergic medications used for the treatment of lower urinary tract symptoms in women.
The study examined large UK primary care database (The Health Improvement Network) and included data for any female patient aged 18 years and above who were prescribed anticholinergic medication. The data included information on 29,369 individuals over a 14 year period. The data were analysed for an overall and drug-specific discontinuation rate based on not ordering for 90 days or more.
By 6 months almost 60% (58.8%) had stopped taking treatment, about three quarters by one year and by 3 years this had risen to 92%. There were no differences between the individual drugs although the sustained release preparations were better tolerated than the immediate release equivalents.
The authors conclude that, "discontinuation rates for anticholinergic medications are high regardless of the class of medication used". They also note that this study cannot identify efficacy, tolerance or other factors as the reason for the high discontinuation rate and further research is recommended.
Action: Clinicians will already be aware that anticholinergic medication is poorly tolerated. This real world data indicates that there is little to differentiate current treatment options.