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Chapple CR, Rosenberg MT, Mueller ER, Chughtai B, Weiss JP, Juul K, Brooks AB, Bacci ED, Andersson FL, Coyne KS, Bosch JR. The patient burden of nocturnal polyuria in the United States: Results from the epidemiology of nocturnal polyuria (EpiNP) study. Neurourol Urodyn 2023; 42:573-585. [PMID: 36655731 DOI: 10.1002/nau.25126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 11/29/2022] [Accepted: 12/19/2022] [Indexed: 01/20/2023]
Abstract
OBJECTIVES To explore the impact of nocturnal polyuria (NP) on health-related quality of life (HRQoL), work productivity, mental health, fatigue, bother, and daytime sleepiness. MATERIALS AND METHODS This large-scale, US population-representative epidemiologic study was conducted in two parts: a web-based survey and 3-day bladder diary. Consenting participants completed the baseline Epidemiology of NP (EpiNP) survey online (Lower Urinary Tract Symptoms [LUTS] Tool, comorbidities, burden, and multiple HRQoL measures). Participants who reported ≥2 voids/night, and a random sample of 100 respondents each reporting 0 or 1 void/night, were sent urine measurement containers and asked to complete the 3-day bladder diary. NP was defined as Nocturnal Polyuria Index >0.33 (NPI33) or nocturnal urine production >90 ml/h (NUP90). Five subgroups were created: Idiopathic NP (NP with no underlying cause), NP associated with symptoms of overactive bladder (NPOAB) or bladder outlet obstruction (NPBOO; men only), NP associated with other comorbidities (NPCOM; e.g., diabetes, hypertension, heart disease, sleep apnea), and no NP (did not meet NP criteria). RESULTS A total of 4893 men and 5297 women completed the EpiNP survey; mean age was 54.4 (SD = 14.7). Significantly greater patient burden (p < 0.0001) was evidenced in the nocturia group (≥2 voids/night) versus no nocturia group (0-1 void/night) on daily impact of nocturia, LUTS Bother, prostate symptoms (men only), work productivity, physical and mental health component scores, depression, fatigue, and daytime sleepiness. NP subgroup analyses showed men in the NPBOO group and women in the NPOAB group reported the greatest impact on LUTS bother, fatigue, physical health, work productivity impairment, daytime sleepiness, and depression (women only). CONCLUSION This was the first large-scale, epidemiologic study to explore the impact of different forms of NP on patients' HRQoL. Findings demonstrate that NP associated with other urologic or comorbid conditions appears to have greater patient burden than idiopathic NP, in particular for women.
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Affiliation(s)
- Christopher R Chapple
- Department of Urology, Sheffield Teaching Hospitals NHS Foundation Trust, University of Sheffield, Sheffield, UK
| | - Matt T Rosenberg
- Department of Family Medicine, Mid Michigan Health Center, Jackson, Michigan, USA
| | - Elizabeth R Mueller
- Departments of Obstetrics/Gynecology & Urology, Division Female Pelvic Medicine & Reconstructive Surgery, Loyola University Medical Center, Maywood, Illinois, USA
| | - Bilal Chughtai
- Department of Urology, Weill Cornell Medical College, New York City, New York, USA
| | - Jeffrey P Weiss
- Department of Urology, SUNY Downstate Health Sciences University, Brooklyn, New York, USA
| | - Kristian Juul
- Global Value and Access, Ferring Pharmaceuticals A/S, Copenhagen, Denmark
| | - Anne B Brooks
- Patient Centered Research, Former employee at Evidera, Bethesda, Maryland, USA
| | | | | | - Karin S Coyne
- Patient Centered Research, Evidera, Bethesda, Maryland, USA
| | - Jlh Ruud Bosch
- Department of Urology, Franciscus G&V Hospital, Rotterdam, The Netherlands
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Varughese S, Rajeev TP, Rodrigues DE, Sucharitha S. Development and Validation of Nocturia-Related Quality of Life Assessment Scale among Adults. JOURNAL OF HEALTH AND ALLIED SCIENCES NU 2023. [DOI: 10.1055/s-0042-1749378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Abstract
Background Nocturia has high impact on quality of life (QoL) based on varying geographical and cultural factors. Speculating this, nocturia-related QoL (NRQoL) assessment scale was developed precisely, appropriate to the Indian context.
Objective The current study aimed to develop and validate an NRQoL assessment scale for Indian adults.
Methods An exploratory descriptive design was performed among 420 cases and 206 controls aged 35 to 65 years from two selected tertiary hospitals in Mangaluru, Karnataka, India. The NRQoL assessment scale was formulated through the following phases: review of literature, evaluation by experts, and pretesting. Exploratory factor analysis (EFA) was performed to reduce the number of items and to define domains. Reliability, construct validity, discriminant validity, and convergent validity of the scale were calculated.
Results EFA resulted in the removal of seven items from a 36-item instrument, resulting NRQoL assessment scale into six domains as follows: (1) functional, (2) sleep, (3) emotional, (4) physical, (5) social and family, and (6) spiritual. The findings from the tertiary hospitals study confirmed that the scale was valid and reliable to measure NRQoL among adults.
Conclusion The NRQoL assessment scale is a new, valid, and reliable instrument that is well-understood by adults and can be answered quickly. It is a useful new tool that can be translated and tested in other cultures and languages.
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Affiliation(s)
- Susamma Varughese
- Department of Medical Surgical Nursing, Father Muller College of Nursing, Nitte University Mangaluru, Mangaluru, Karnataka, India
| | | | - Devina E. Rodrigues
- Department of Community Health Nursing, Father Muller College of Nursing, Mangaluru, Karnataka, India
| | - Suresh Sucharitha
- Department of Hospital Administration, Father Muller Medical College, Mangaluru, Karnataka, India
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Weiss JP, Bosch JLHR, Chapple CR, Bacci ED, Simeone JC, Rosenberg MT, Mueller ER, Andersson FL, Juul K, Chughtai B, Coyne KS. The Prevalence of Nocturnal Polyuria in the United States: Results from the Epidemiology of Nocturnal Polyuria Study. Eur Urol Focus 2022; 8:1415-1423. [PMID: 35039242 DOI: 10.1016/j.euf.2021.12.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Accepted: 12/28/2021] [Indexed: 12/16/2022]
Abstract
BACKGROUND The prevalence of nocturnal polyuria (NP), which is passing large volumes of urine during the main sleep period, has been investigated primarily in middle-aged to older men. There is thus a gap in the NP evidence base for women and for younger individuals. OBJECTIVE To estimate the prevalence of nocturia due to NP in the USA. DESIGN, SETTING, AND PARTICIPANTS This large epidemiologic study used a US population-representative sample of men and women aged ≥30 yr to assess the prevalence of NP (NCT04125186). OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS Consenting participants completed an online survey (Lower Urinary Tract Symptoms Tool and comorbidities). All who reported two or more voids per night and 100 random respondents each reporting no or one void per night were asked to complete a 3-d bladder diary. Two NP definitions were used: nocturnal urine production >90 ml/h (NUP90) and Nocturnal Polyuria Index >0.33 (NPI33). Crude and population-adjusted prevalence results were calculated from completed diaries for the following subgroups by sex and age: idiopathic NP; NP with overactive bladder (NP-OAB) or bladder outlet obstruction (NP-BOO; men only); NP associated with other comorbidities; and no NP (did not meet the NPI33 or NUP90 definition). RESULTS AND LIMITATIONS Among the 10,190 respondents who completed the survey, the mean age was 54.4 yr (range 30-95); 3,339 reported two or more nocturnal voids and 1,763 completed the 3-d diary (response rate 49.3%). The adjusted overall NP prevalence was 31.5% among men and 38.5% among women using the NPI33 definition, and 23.8% among men and 18.1% among women using NUP90. The adjusted idiopathic NP prevalence was lower among men (NPI33: 5.2%; NUP90: 1.4%) than among women (NPI33: 9.8%; NUP90: 4.0%). The prevalence of idiopathic NP decreased with age as NP associated with other possible causes increased with age in men (most common, BOO) and women (most common, OAB). CONCLUSIONS This is the first population-based study of NP prevalence to include men, women, and young adults. NP is common; a multifactorial etiology should be considered, particularly as age increases. PATIENT SUMMARY In this population-based US study, we examined the frequency of nighttime urination among men and women aged ≥30 y and older. We found that nighttime urination is common among men and women. Many conditions can lead to increased nighttime urination as people age.
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Affiliation(s)
- Jeffrey P Weiss
- SUNY Downstate Health Sciences University, Brooklyn, NY, USA
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Hudgens S, Howerter A, Polek E, Andersson FL. Psychometric validation and interpretation of the Nocturia Impact Diary in a clinical trial setting. Qual Life Res 2021; 31:1837-1848. [PMID: 34932192 PMCID: PMC9098619 DOI: 10.1007/s11136-021-03060-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/03/2021] [Indexed: 12/02/2022]
Abstract
Purpose Psychometric evaluation of the Nocturia Impact (NI) Diary was conducted to support its use as a trial endpoint. Methods As part of a randomized, controlled Phase 2 clinical trial investigating a novel drug candidate for nocturnal polyuria, adult nocturia patients completed the NI Diary and a voiding diary for three nights preceding their clinic visit at Baseline and Weeks 1, 4, 8, and 12 (end of treatment). Exit interviews were conducted to obtain patient impressions of the NI Diary. Results A total of N = 302 participants were included. Confirmatory factor analysis (CFA) indicated that the 11-item measure is unidimensional with values of CFI, TLI, and RMSEA meeting relevant thresholds. Good internal consistency (Cronbach’s α 0.941) and test–retest reliability (intra-class correlation coefficients 0.730–0.880). Convergent validity with two reference measures was demonstrated with strong correlations of 0.573–0.730 were shown. Significant differences (P = 0.0018, standardized effect size = 0.372) between groups defined by number of night-time voids supported known-groups validity. Exit interviews in 66 patients indicated all participants experienced improvement in at least 1 NI Diary item and that a 1-point improvement on the item response scale and 1-void reduction per night (associated with an average best cut point on ROC analysis of − 11.6) constituted meaningful improvement. Anchor and distribution-based analyses identified a meaningful change threshold of − 15 to − 18 points on the NI Diary. Conclusion The NI Diary is a reliable and valid patient-reported psychometric instrument which is fit-for-purpose to evaluate the impact of nocturia on patient quality of life in the clinical trial setting. Trial registration number and registration date NCT03201419; June 28, 2017. Supplementary Information The online version contains supplementary material available at 10.1007/s11136-021-03060-4.
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Affiliation(s)
- Stacie Hudgens
- Clinical Outcomes Solutions, Tucson, AZ, USA. .,Clinical Outcomes Solutions, 1820 E River Rd, Ste 220, Tucson, AZ, 85718, USA.
| | | | - Ela Polek
- Clinical Outcomes Solutions, Folkestone, UK
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Williams V, Qin S, Romano CD, Lewis S, Williams N, Yarr S, Juul KV, Andersson FL. Psychometric evaluation of the Nocturia Sleep Quality Scale based on data from a prospective observational study. J Clin Sleep Med 2021; 17:691-701. [PMID: 33206043 PMCID: PMC8020686 DOI: 10.5664/jcsm.9010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 11/09/2020] [Accepted: 11/10/2020] [Indexed: 11/13/2022]
Abstract
STUDY OBJECTIVES The Nocturia Sleep Quality Scale (NSQS), a novel patient-reported outcomes measure, was developed to assess the impact of sleep disturbance from nocturia. The objective of this study was to assess the psychometric properties of the NSQS, including its structure, reliability, and validity. METHODS Data were collected in the context of a web-based, prospective, longitudinal, observational study. Participants with nocturia were randomized 1:1 to either a group that received sleep hygiene instructions, including instructions to limit liquids at nighttime and empty bladder prior to bedtime, or one that did not receive sleep instructions. All participants were asked to provide responses to the web-based questionnaires from day 1 to day 10. Psychometric analyses, aligned with current regulatory guidance, were conducted to evaluate the daily scores and 3-day average scores of NSQS items and potential composites. Item-level analyses were conducted first, followed by composite-level analyses. RESULTS The NSQS items and supporting measures demonstrated very slight improvement in patient-perceived sleep disturbance from nocturia over the course of the study. NSQS test-retest reliabilities were generally satisfactory. Correlations between NSQS items and related patient-reported measures tended to support the construct validity of the NSQS, and the known-groups analyses supplied evidence of its discriminating ability. NSQS responsiveness statistics were small. CONCLUSIONS The NSQS is a reliable and valid measure of the impact of nocturia on patients' sleep. The present analyses lay the psychometric groundwork for the use of the NSQS in future clinical trials to support product approval and labeling claims.
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Affiliation(s)
| | - Shanshan Qin
- RTI Health Solutions, Research Triangle Park, North Carolina
| | | | - Sandy Lewis
- RTI Health Solutions, Research Triangle Park, North Carolina
| | - Nicole Williams
- RTI Health Solutions, Research Triangle Park, North Carolina
| | - Stuart Yarr
- RTI Health Solutions, Research Triangle Park, North Carolina
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Rose GE, Ervin C, Bower WF. Sleep quality matters more to community-dwelling individuals than nocturia frequency. JOURNAL OF CLINICAL UROLOGY 2019. [DOI: 10.1177/2051415819856235] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objective: The objective of this study is to identify variables that describe nocturia-related bother in a sample of community-dwelling individuals. Materials and methods: Community-dwelling individuals age 40 years and older who woke to pass urine at night completed an online questionnaire. Participants were asked (i) their top three concerns in relation to nocturia, (ii) to agree or disagree with a list of statements related to bother, and (iii) to complete the Nocturia Impact Diary items. Fisher exact test and the Mann–Whitney U test were used to assess whether differences in nocturia-related bother existed when comparing participants stratified by nocturia severity. Results: Moderate to extreme nocturia-related bother was described by 56% of the 202 respondents and by 68% of individuals with nocturia two or more times per night. Effects of nocturia, specifically sleep disruption and impact on daytime function, were the most cited concerns. Low nocturia-related health literacy was evident. The sample was younger (83% age <70 years), predominantly female (74%) and nocturia treatment naïve (95%). Conclusion: The study highlights the potential to evaluate patient care based on change in sleep and daytime function rather than solely on nocturia frequency. A suite of patient-reported outcome measures adjunctive to clinical data may have utility in quantifying meaningful change to patients after treatment for nocturia. Level of evidence: Not applicable for this multicentre audit.
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Affiliation(s)
- GE Rose
- Department of Medicine & Aged Care, The Royal Melbourne Hospital, Australia
| | - C Ervin
- Sub-Acute Care Services, Department of Medicine & Aged Care, The Royal Melbourne Hospital, Australia
| | - WF Bower
- Department of Medicine & Aged Care, The Royal Melbourne Hospital, Australia
- Faculty of Medicine, Dentistry & Health Sciences, The University of Melbourne, Australia
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Rose GE, Denys M, Kumps C, Whishaw DM, Khan F, Everaert KC, Bower WF. Nocturnal voiding frequency does not describe nocturia‐related bother. Neurourol Urodyn 2019; 38:1648-1656. [DOI: 10.1002/nau.24029] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Revised: 02/27/2019] [Accepted: 04/25/2019] [Indexed: 12/24/2022]
Affiliation(s)
- Georgie E. Rose
- Department of Medicine & Aged CareRoyal Melbourne HospitalParkville Victoria Australia
| | | | - Candy Kumps
- Department of UrologyGhent University HospitalGhent Belgium
| | - David M. Whishaw
- Department of Medicine & Aged CareRoyal Melbourne HospitalParkville Victoria Australia
| | - Fary Khan
- Department of Rehabilitation MedicineRoyal Melbourne HospitalParkville Victoria Australia
| | | | - Wendy F. Bower
- Department of Medicine & Aged CareRoyal Melbourne HospitalParkville Victoria Australia
- Faculty of Medicine, Dentistry and Health SciencesThe University of MelbourneVictoria Australia
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Everaert K, Anderson P, Wood R, Andersson FL, Holm-Larsen T. Nocturia is more bothersome than daytime LUTS: Results from an Observational, Real-life Practice Database including 8659 European and American LUTS patients. Int J Clin Pract 2018; 72:e13091. [PMID: 29767479 DOI: 10.1111/ijcp.13091] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2017] [Accepted: 03/25/2018] [Indexed: 11/29/2022] Open
Abstract
PURPOSE Lower urinary tract symptoms (LUTS) encompass several diagnoses, including overactive bladder (OAB) and benign prostatic hyperplasia (BPH). Nocturia is a standalone symptom, but also included in OAB and BPH. Current discussion addresses whether the overlap of the diagnoses is too broad, leading to misdiagnosis. This study explored the differences in level, causes and consequences for patients with a diagnosis of daytime LUTS compared with a diagnosis of nocturia, and discussed whether people are being treated for the symptoms that truly bother them the most. PATIENTS AND METHODS Data were drawn from a survey of physicians and patients in France, Germany, Spain, UK and USA. Physicians filled out patient record forms (PRFs) for patients with LUTS diagnosis. The patients completed the patient self-completion form (PSC). Three PRO questionnaires were included; the OAB-q SF, NI-Diary and WPAI. Patients were grouped based on the diagnoses assigned to them by their physicians in a real-life setting. RESULTS Eight thousand seven hundred and thirty eight patients had a LUTS diagnosis and 5335 completed a PSC. Patients diagnosed with night-time symptoms were significantly more bothered by their LUTS than only daytime LUTS patients (all questionnaires P < .0001). Patients with nocturia reported being tired "always" or "usually" more often than patients with daytime problems only (P < .0001). Only 13% of patients with nocturia had an initial sleep period of more than 2-3 hours. CONCLUSION In this population of real-life patients, those with a diagnosis of nocturia reported significantly higher impact on their quality of life than patients with a diagnosis of daytime LUTS only. The underlying causes of bother were related to sleep problems. It is essential that nocturia is understood, treated and monitored as a distinct problem from OAB and BPH, to ensure that patients are treated for their main symptom.
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Affiliation(s)
- Karel Everaert
- Nopia research group, Department of Urology, Ghent University Hospital, Ghent, Belgium
| | - Peter Anderson
- Adelphi Real World, Adelphi Mill, Bollington, Macclesfield, UK
| | - Robert Wood
- Adelphi Real World, Adelphi Mill, Bollington, Macclesfield, UK
| | - Fredrik L Andersson
- Ferring Pharmaceuticals A/S, Copenhagen, Denmark
- Center for Medical Technology Assessment (CMT), Linköping University, Linköping, Sweden
| | - Tove Holm-Larsen
- Nopia research group, Department of Urology, Ghent University Hospital, Ghent, Belgium
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Abrams S, Martin S, Gillard KK, Cheng L, Fein S. Development of the Impact of Nighttime Urination (INTU) questionnaire to assess the impact of nocturia on health and functioning. Neurourol Urodyn 2018; 37:1686-1692. [PMID: 29566269 DOI: 10.1002/nau.23453] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2017] [Accepted: 10/18/2017] [Indexed: 11/08/2022]
Abstract
AIMS This study describes development of the Impact of Nighttime Urination (INTU) questionnaire to assess nocturia impacts on health and functioning. METHODS Development of the questionnaire followed an iterative patient-directed process as recommended by current guidance for patient-reported outcome (PRO) measures. An initial 15-item questionnaire was devised based on reviewing the published literature, and then modified through four rounds of semi-structured interviews of 28 individuals with nocturia. In each round, open-ended concept elicitation, followed by cognitive debriefing, was used to assess the questionnaire. Items were modified based on participants' responses and incorporated into the next round of interviews. RESULTS In all rounds, participants reported that their experiences were easy to recall and report on a daily basis and that the burden of completing the questionnaire was low. The final questionnaire has a same-day recall period. It includes six daytime impact items-having limited concentration, a sense of feeling tired, difficulty getting things done, irritability, not feeling rested, and drowsiness-and four items that measure the nighttime impact of nocturia-patient concern, waking up too early, difficulty getting enough sleep, and feeling bothered by having to get up at night to void. Responses follow a 5- or 4-point scale. The final INTU captures the key concepts associated with nocturia as confirmed by cognitive debriefing. CONCLUSIONS Development of the 10-item INTU, a nocturia-specific PRO measure, was based on direct input and feedback from patients and has demonstrated that it captures the patient-reported impacts of nocturia.
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Affiliation(s)
| | | | | | - Linda Cheng
- Serenity Pharmaceuticals, LLC, Milford, Pennsylvania
| | - Seymour Fein
- Serenity Pharmaceuticals, LLC, Milford, Pennsylvania
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ROVNER ES, RAYMOND K, ANDRUCZYK E, JUUL KV. Low-dose Desmopressin and Tolterodine Combination Therapy for Treating Nocturia in Women with Overactive Bladder: A Double-blind, Randomized, Controlled Study. Low Urin Tract Symptoms 2017; 10:221-230. [DOI: 10.1111/luts.12169] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2016] [Revised: 12/07/2016] [Accepted: 01/15/2017] [Indexed: 12/31/2022]
Affiliation(s)
- Eric S. ROVNER
- Department of Urology, Medical University of South Carolina; Charleston South Carolina USA
| | | | - Eugene ANDRUCZYK
- Clinical Research of Philadelphia, LLC; Philadelphia Pennsylvania USA
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Andersson F, Anderson P, Holm-Larsen T, Piercy J, Everaert K, Holbrook T. Assessing the impact of nocturia on health-related quality-of-life and utility: results of an observational survey in adults. J Med Econ 2016; 19:1200-1206. [PMID: 27388879 DOI: 10.1080/13696998.2016.1211136] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND AND AIM The impact of nocturia (getting up at night to void) on health-related quality-of-life (HRQoL) is often under-estimated. This study investigated the relative burden in terms of HRQoL and utilities of nocturia in a real-world setting. METHODS Patient data were collected from two surveys: a nocturia-specific, cross-sectional survey of physicians and their patients (DSP), and a general UK population health survey (HSFE). Utilities (EQ-5D-5L), productivity (Work Productivity and Activity Index), and the impact of nocturia symptoms (Nocturia Impact Diary and Overactive Bladder Questionnaires) were assessed against the number of voids. A robust linear regression model with propensity score weights was used to control for confounding factors in estimating utilities. RESULTS Physician-recorded data were available from 8,738 patients across the US, Germany, Spain, France, and the UK; of these, 5,335 (61%) included patient-reported outcomes. In total, 6,302 controls were drawn from the two surveys and compared to 1,104 nocturia patients. Deterioration of HRQoL was associated with increasing number of night-time voids (p < 0.0001). In particular, significant differences were observed between 0-1 and ≥2 voids (p < 0.001). The regression model demonstrated that nocturia (≥2 per night) is associated with a modest but significant deterioration in utility of 0.0134 (p < 0.05). LIMITATIONS The cause of nocturia is multifactorial and the mostly elderly patients may have several concomitant diseases. The authors tried to adjust for the most common ones, but there may be diseases or unknown relationships not included. CONCLUSIONS Nocturia negatively affected HRQoL and patient utility. A clear effect is seen already at two voids per night. Every effort should, therefore, be made to reduce nocturia below the bother threshold of two voids per night.
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Affiliation(s)
- Fredrik Andersson
- a Ferring Pharmaceuticals A/S , Copenhagen , Denmark
- b Center for Medical Technology Assessment (CMT), Linköping University , Linköping , Sweden
| | | | | | - James Piercy
- c Adelphi Real World , Bollington , Cheshire , UK
| | - Karel Everaert
- e Department of Urology , Ghent University Hospital , Ghent , Belgium
| | - Tim Holbrook
- c Adelphi Real World , Bollington , Cheshire , UK
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Kim JW, Moon YT, Kim KD. Nocturia: The circadian voiding disorder. Investig Clin Urol 2016; 57:165-73. [PMID: 27195315 PMCID: PMC4869573 DOI: 10.4111/icu.2016.57.3.165] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2016] [Accepted: 04/22/2016] [Indexed: 11/23/2022] Open
Abstract
Nocturia is a prevalent condition of waking to void during the night. The concept of nocturia has evolved from being a symptomatic aspect of disease associated with the prostate or bladder to a form of lower urinary tract disorder. However, recent advances in circadian biology and sleep science suggest that it might be important to consider nocturia as a form of circadian dysfunction. In the current review, nocturia is reexamined with an introduction to sleep disorders and recent findings in circadian biology in an attempt to highlight the importance of rediscovering nocturia as a problem of chronobiology.
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Affiliation(s)
- Jin Wook Kim
- Department of Urology, Chung-Ang University, Seoul, Korea
| | - Young Tae Moon
- Department of Urology, Chung-Ang University, Seoul, Korea
| | - Kyung Do Kim
- Department of Urology, Chung-Ang University, Seoul, Korea
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