Worsening lower urinary tract symptoms (LUTS) is associated with a greater likelihood of skipping diuretic doses, according to study findings presented at the ICS 2020 Online, a virtual conference organized by the International Continence Society.

The findings emerged from an analysis of survey responses from 280 individuals who used diuretics. Participants had a mean age of 61 years, and 70.4% were female. Most (57%) took diuretics to treat hypertension. Investigators Matthew Miller, a medical student at the University of Maryland in Baltimore, Maryland, and colleagues evaluated LUTS severity using the Overactive Bladder Questionnaire-Short Form (OAB-q SF). They used 3 approaches to assess adherence to diuretic use: Adherence to Refills and Medications Scale; Self-Efficacy for Managing Medications and Treatment-Short Form; and a yes-or-no question asking participants if they skip diuretic doses due to increased urinary frequency or worsening stress urinary incontinence (SUI).

Of the 280 participants, 54 (19.3%) indicated they skipped diuretic doses due to increased LUTS: 33 due to increased urinary frequency, 3 due to worsening SUI, and 18 due to both.

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The mean OAB-q SF score for the entire cohort was 22.2, but was significantly higher for nonadherent vs adherent patients (32.6 vs 19.7).

Each additional 1-point increase in OAB-q SF score was significantly associated with 3.5% increased odds of skipping diuretic doses due to increased urinary frequency and 7.3% increased odds of skipping diuretic doses dues to worsening SUI, Miller reported. The results held after adjusting for multiple potential confounders.

“These results support our hypothesis that more severe urinary symptoms are associated with poorer diuretic adherence. This is the first study to examine the relationship of urinary symptoms and diuretic adherence in participants with a variety of chronic diseases,” Miller concluded.


Miller M, Malik R, Reed B. Impact of lower urinary tract symptoms on diuretic adherence. Presented at: ICS 2020 virtual conference, November 19-22. Abstract 148.