Loss to follow-up for overactive bladder (OAB) care is common and inadequately understood.
The objective of this study was to estimate the association between race, ethnicity, socioeconomic advantage, and loss to follow-up in women initiating OAB treatment. Secondary objectives included comparing treatment patterns.
This study included a retrospective cohort of patients initiating OAB treatment at an academic, tertiary referral center, September 1, 2016, to March 1, 2022. Women with baseline OAB symptom severity data who self-reported language, race, and ethnicity were included. The underrepresented cohort was defined as those self-identifying as Black or Spanish-speaking, Hispanic. Socioeconomic advantage was quantified using the area deprivation index (ADI). To detect a relative risk of 1.3 for loss to follow-up (no follow-up within 13 months of initiating treatment, α= 0.05, β=0.2, 1:3 ratio), 632 patients were needed.
Six hundred thirty-two patients (mean age 60.48 ± 15.57 y) were included; 159/632 (25%) were underrepresented. Underrepresented patients had an increased risk of loss to follow-up on regression analysis adjusted for socioeconomic advantage, insurance, symptom impact, and menopause status (adjusted risk ratio [aRR] 6.91, 95% CI: 1.69-28.26). The ADI was associated with loss to follow-up on models adjusted for insurance, prolapse stage, symptoms and menopause status (aRR 1.03, 95% CI: 1.004-1.07, P =0.03). There were differences related to initial treatment with anticholinergic medication (34.1% Black, 50.7% Hispanic, 24.9% White, P <0.01), first follow-up (26.3 + 40.9 wk Black, 12.8 + 19.3 wk Hispanic, and 17.1 + 17 wk White, P <0.01), and receipt of advanced therapies (8.0% Black, 2.8% Hispanic, 12.9% White, P =0.02).
Sociodemographic variables may be associated with treatment patterns after initiating care for OAB.
Urogynecology (Philadelphia, Pa.). 2026 Jun 01*** epublish ***
Julia K Shinnick, Ghazal Aghagoli, Tess Cersonsky, Anne Bocage, Spandana Jarmale, Lauren E Schlichting, Vivian W Sung
Department of Obstetrics & Gynecology, Division of Urogynecology, Warren Alpert Medical School of Brown University, Providence, RI., Department of Obstetrics and Gynecology, Duke University, Durham, NC., Department of Obstetrics, Icahn School of Medicine, Mount Sinai Hospital, New York, NY., Department of Obstetrics & Gynecology, Sidney Kimmel Medical College of Thomas Jefferson University, Philadelphia, PA., Department of Ophthalmology, Icahn School of Medicine-Mount Sinai Hospital, New York, NY., Hassenfeld Child Health Innovation Institute, Brown University, Providence, RI.