Educational Tools for Diagnosing and Treating Overactive Bladder

New Orleans—Despite the fact that overactive bladder (OAB) affects up to 20% of US adults, the condition remains underdiagnosed and undertreated. OAB can negatively impact social, psychological, occupational, domestic, physical, and sexual functioning.

A recent study sought to evaluate the effectiveness of an online personalized learning curriculum in order to improve OAB diagnosis and care among primary care physicians (PCPs). The study was presented by Simi Hurst and colleagues during a session at the AUA 2015 Annual Meeting.

The online practice tool used in the study identified gaps in knowledge, skills, or performance related to managing patients with OAB. Each self-assessment question was aligned with one of three practice gap categories and one of three interactive continuing medical education (CME) multimedia educational modules.

The self-assessment and CME were launched simultaneously on March 27, 2014, and each physician was directed to one or more relevant CME modules based on their individual educational needs that were identified by the outcomes of the self-assessment.

The researchers measured educational effectiveness via a statistical comparison between responses to questions in the self-assessment at baseline and responses to the same question following participation in the modules.

The study has collected data from 1979 healthcare providers at the time of the presentation, though results from just 194 PCPs were provided, of whom had participated between the launch date in 2014 and May 2014.

The first practice gap studied was effective communication strategies to promote adherence to therapy, which included 143 PCPs. At baseline, 7% had counseled patients on the commitment needed for behavioral therapy compared with 44% after the assessment was completed (P<.001). In addition, at baseline, 52% of PCPs had proactively communicated the potential side effects associated with treatment compared with 82% post-assessment (P<.001).

The second practice group studied was provision of appropriate treatment, ongoing care, and timely referral and included 100 PCPs. At baseline, 53% had identified appropriate factors for guiding treatment strategy selection compared with 74% post-assessment (P<.001). At baseline, 62% of PCPs had evaluated the treatment response during follow-up care compared with 76% after the self-assessment (P<.008).

The third practice group studied was the management of OAB in patients in the long-term care (LTC) setting, which included 93 PCPs. At baseline, 70% had appropriately evaluated urinary symptoms compared with 85% post-assessment (P<.002). In addition, at baseline, 40% had implemented nonpharmacologic therapies for elderly LTC patients with OAB when appropriate compared with 72% after the self-assessment (P<.001). Lastly, at baseline, 23% of PCPs had selected OAB therapies for the elderly patients that had minimal potential for drug─drug interactions and side effects compared with 44% post-assessment (P<.001).

The researchers concluded that “PCPs were significantly more likely to make evidence-based decisions after completing their recommended modules.” The Advanced Decision-Making in OAB Personalized Learning curriculum resulted in significantly improved physician competence, confidence, and performance.

Source: Hurst S, Barnes J, Rhodes E. Advancing care for overactive bladder: A tailored learning approach to improve clinical decision-making. Abstract of a presentation at the American Urological Association 2015 Annual Meeting, New Orleans, Louisiana, May 17, 2015.

This study was supported by independent educational grants from Allergan and Astellas.