The antimuscarinic agent, oxybutynin, has consistently demonstrated higher rates of cognitive impairment in the elderly — and appears to be commonly prescribed in this age group for the treatment of overactive bladder (OAB) — new data show.
“In fact, the prescription rate for oxybutynin in patients 65 years of age or older is so high as to be alarming,” Christian Meyer, MD, Brigham and Women’s Hospital, Boston, said recently at the 32nd Annual European Association of Urology Congress in London, England.
He presented results from an examination of antimuscarinic-prescribing patterns in older patients using data from the 2006-2012 National Hospital Ambulatory Medical Care Survey (NHAMCS).
The NHAMCS survey compiles data on the utilization and provision of ambulatory-care services in hospital emergency and outpatient departments. Findings are based on a national sample of visits to the emergency departments and outpatient departments of noninstitutional general and short-stay hospitals.
Dr Meyer and his colleagues aimed to determine how often elderly patients received a new prescription or a repeat prescription for any of six antimuscarinic agents for OAB. These included oxybutynin, tolterodine, fesoterodine, darifenacin, solifenacin and trospium.
While behavioral interventions are a fundamental component of OAB management, antimuscarinics are the mainstay of pharmacologic treatment.