Prescribing Patterns and Treatment Persistence for Overactive Bladder in Japan Across Medical Specialties and Facility Types: A Nationwide Claims Database Study.

OBJECTIVES

To describe real-world initial pharmacotherapy, treatment persistence, and diagnostic testing for overactive bladder in Japan by medical specialty and facility type.

METHODS

This retrospective descriptive study used nationwide administrative claims data. Patients aged 15 years or older diagnosed with overactive bladder in 2022 who newly initiated pharmacotherapy were followed for 1 year. Analyses were conducted across four groups defined by medical specialty and facility type. We summarized initial medication, baseline comorbidities, one-year treatment persistence, and performance of urinalysis and postvoid residual volume measurement at diagnosis and within 1-3 months thereafter.

RESULTS

Of 702 078 patients diagnosed with overactive bladder, 65 173 met the eligibility criteria (median age 80 years; interquartile range 74.0-85.0; women 56.3%). β3-adrenoceptor agonists accounted for more than 70% of initial prescriptions in both urology and internal medicine, whereas anticholinergics were used more often in internal medicine than in urology. Baseline comorbidities, including dementia, were broadly similar between patients initiating β3-adrenoceptor agonists and those initiating anticholinergics, except for benign prostatic hyperplasia. At 1 year, persistence was higher for β3-adrenoceptor agonists than for anticholinergics and other drugs, but remained below 30% for β3-adrenoceptor agonists. Urinalysis and postvoid residual volume measurement were performed more frequently in urology than in internal medicine.

CONCLUSIONS

β3-adrenoceptor agonists predominated as initial pharmacotherapy for overactive bladder in Japan, whereas anticholinergics were used more often in internal medicine than in urology. Similar comorbidity profiles and specialty-related differences in diagnostic testing highlight opportunities to optimize individualized prescribing and strengthen guideline-concordant evaluation across care settings.