Oxybutynin Overprescribed for Overactive Bladder in Elderly
Pharmacologic properties of oxybutynin may cause significant cognitive side effects in elderly persons.
(HealthDay News) — The incidence of oxybutynin prescription was 27.3% among elderly individuals receiving antimuscarinic prescriptions from 2006 to 2012, according to a study presented at the annual meeting of the European Association of Urology, held from March 24 to 28 in London.
Noting that the first-line therapy for overactive bladder is antimuscarinic medication, some of which have deleterious side effects, including cognitive decline, Daniel Pucheril, MD, of the Vattikuti Urology Institute at the Henry Ford Hospital in Detroit, and colleagues examined the incidence and prevalence of antimuscarinic prescriptions among adults aged ≥65 years. Data were extracted from the 2006 to 2012 National Ambulatory Medical Care Survey.
The researchers found that a weighted estimate of 47.68 million individuals had their antimuscarinics renewed and 12.77 million received a new prescription. Most new antimuscarinics were prescribed in elderly, female, white, and Medicare-insured individuals (55.2%, 69.2%, 61.7%, and 84.1%, respectively). Among elderly patients, oxybutynin was frequently prescribed and continued (incidence, 27.3%; prevalence, 33.2%). There was a sharp decline in the number of all continued antimuscarinic prescriptions in 2010, followed by annual increases in continuation of oxybutynin versus continued decline in continuation of other antimuscarinics.
"Oxybutynin is the least expensive antimuscarinic drug available, but its pharmacologic properties may cause significant cognitive side effects in elderly persons," Pucheril said in a statement. "Despite evidence of these side effects, physicians are not commonly checking for cognitive effects in those using these medications."
- Concern over high US prescribing levels of common drug linked to dementia [press release]. European Association of Urology National Meeting. March 24-28 2017.