Inequities in Filled Overactive Bladder Medication Prescriptions in the US

Topic: Risk, prevention and care in population studies

An estimated 2 971 449 individuals (mean age, 66.4 years; 95% CI, 64.8-68.2 years) filled prescriptions for OAB medications in 2019; 2 185 214 (73.5%; 95% CI, 62.6%-84.5%) identified as female, 2 326 901 (78.3%; 95% CI, 66.3%-90.3%) self-identified as non-Hispanic White, 260 685 (8.8%; 95% CI, 5.0%-12.5%) identified as non-Hispanic Black, 167 210 (5.6%; 95% CI, 3.1%-8.2%) identified as Hispanic, 158 507 (5.3%; 95% CI, 2.3%-8.4%) identified as non-Hispanic other race, and 58 147 (2.0%; 95% CI, 0.3%-3.6%) identified as non-Hispanic Asian. A total of 2 229 297 individuals (75.0%) filled an anticholinergic prescription, and 590 255 (19.9%) filled a β3-agonist prescription, with 151 897 (5.1%) filling prescriptions for both medication classes. β3-agonists had a median out-of-pocket cost of $45.00 (95% CI, $42.11-$47.89) per prescription compared with $9.78 (95% CI, $9.16-$10.42) for anticholinergics. After controlling for insurance status, individual sociodemographic factors, and medical contraindications, non-Hispanic Black individuals were 54% less likely than non-Hispanic White individuals to fill a prescription for a β3-agonist vs an anticholinergic medication (adjusted odds ratio, 0.46; 95% CI, 0.22-0.98). In interaction analysis, non-Hispanic Black women had an even lower odds of filing a β3-agonist prescription (adjusted odds ratio, 0.10; 95% CI, 0.04-0.27). Conclusions and Relevance: In this cross-sectional study of a representative sample of US households, non-Hispanic Black individuals were significantly less likely than non-Hispanic White individuals to have filled a β3-agonist prescription compared with an anticholinergic OAB prescription. These differences may reflect an inequity in prescribing behaviors promulgating health care disparities. Targeted research should assess the relative contribution of a variety of individual and societal factors.

Key findings

• An estimated 2 971 449 individuals (mean age, 66.4 years; 95% CI, 64.8-68.2 years) filled prescriptions for OAB medications in 2019; 2 185 214 (73.5%; 95% CI, 62.6%-84.5%) identified as female, 2 326 901 (78.3%; 95% CI, 66.3%-90.3%) self-identified as non-Hispanic White, 260 685 (8.8%; 95% CI, 5.0%-12.5%) identified as non-Hispanic Black, 167 210 (5.6%; 95% CI, 3.1%-8.2%) identified as Hispanic, 158 507 (5.3%; 95% CI, 2.3%-8.4%) identified as non-Hispanic other race, and 58 147 (2.0%; 95% CI, 0.3%-3.6%) identified as non-Hispanic Asian.
• A total of 2 229 297 individuals (75.0%) filled an anticholinergic prescription, and 590 255 (19.9%) filled a β3-agonist prescription, with 151 897 (5.1%) filling prescriptions for both medication classes. β3-agonists had a median out-of-pocket cost of $45.00 (95% CI, $42.11-$47.89) per prescription compared with $9.78 (95% CI, $9.16-$10.42) for anticholinergics.
• After controlling for insurance status, individual sociodemographic factors, and medical contraindications, non-Hispanic Black individuals were 54% less likely than non-Hispanic White individuals to fill a prescription for a β3-agonist vs an anticholinergic medication (adjusted odds ratio, 0.46; 95% CI, 0.22-0.98).
• In interaction analysis, non-Hispanic Black women had an even lower odds of filing a β3-agonist prescription (adjusted odds ratio, 0.10; 95% CI, 0.04-0.27).
• Conclusions and Relevance: In this cross-sectional study of a representative sample of US households, non-Hispanic Black individuals were significantly less likely than non-Hispanic White individuals to have filled a β3-agonist prescription compared with an anticholinergic OAB prescription.

Why it matters

This study looked at who filled prescriptions for overactive bladder medications and found that non-Hispanic Black individuals, especially women, were less likely to receive β3-agonist medications than anticholinergics. It does not test any treatment for Alzheimer's disease and provides no information about curing or preventing it.

Study details

• Study designcross-sectional
• Participants449
• Effect size73.5%; 62.6%; 84.5%
• Evidence strengthLow

Read the original

• DOI: 10.1001/jamanetworkopen.2023.15074
• PubMed: 37223899
• Original source →
• Free full text: JAMA Network Open →

Full text: free to read — OpenAlex lists this copy as free to read: the link above (checked 6 Feb 1020).

@article{luchristt2023-37223899,
  author  = {Luchristt, Douglas and Bretschneider, Carol Emi and Kenton, Kimberly Sue and Simon, Melissa Andrea and Brown, Oluwateniola},
  title   = {{Inequities in Filled Overactive Bladder Medication Prescriptions in the US}},
  journal = {JAMA Network Open},
  year    = {2023},
  doi     = {10.1001/jamanetworkopen.2023.15074},
  pmid    = {37223899},
  url     = {https://doi.org/10.1001/jamanetworkopen.2023.15074}
}

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• Anticholinergic Drug Exposure and the Risk of Dementia: A Nested Case-Control Study JAMA internal medicine · 2019-08-01 · usefulness score 74/100 · Getting a diagnosis
• Association Between Anticholinergic Medication Use and Cognition, Brain Metabolism, and Brain Atrophy in Cognitively Normal Older Adults JAMA neurology · 2016-06-01 · usefulness score 63/100 · Caregiving
• Trends in Relative Incidence and Prevalence of Dementia Across Non-Hispanic Black and White Individuals in the United States, 2000-2016 JAMA neurology · 2021-03-01 · usefulness score 59/100 · Disparities
• Black and White individuals differ in dementia prevalence, risk factors, and symptomatic presentation Alzheimer's & dementia : the journal of the Alzheimer's Association · 2021-12-02 · usefulness score 57/100 · Disparities

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