Psychometric equivalence of the OAB-q in Danish, German, Polish, Swedish, and Turkish

Psychometric evaluation of the Overactive Bladder Questionnaire (OAB-q) for measuring quality of life and clinical implications in Greek patients with overactive bladder

INTRODUCTION AND HYPOTHESIS

The Overactive Bladder Questionnaire (OAB-q) measures overactive bladder patients' severity of symptoms and their impact on health-related quality of life (HRQoL). The aim of this study was to validate the OAB-q in Greek patients with overactive bladder and report clinical implications of the disease.

METHODS

In total, 107 patients were recruited consecutively in our clinic. They completed the OAB-q and Short Form-36 Health Survey (SF-36) twice, 3 months apart. Simultaneously, they initiated lifestyle changes and drug therapy. The reliability of OAB-q was estimated by its internal consistency (Cronbach's α). Validity was estimated by criterion validity and concurrent validity by comparison with SF-36.

RESULTS

The sample's mean age was 62.1 years, and 74.8% were women. Cronbach's α exceeded the 0.7 threshold in all OAB-q subscales, implying good reliability of internal consistency for the OAB-q. In addition, moderate (Pearson's r > 0.3) or strong (r > 0.5) correlations were observed between OAB-q subscales and the relevant SF-36 subscales, implying concurrent validity. Clinically, urgency incontinence affected symptom bother (p = 0.001), concern/worry (p = 0.031) and social interaction (p = 0.027). Nocturia had the largest impact on HRQoL in patients with overactive bladder, as it affected all the OAB-q subscales (p < 0.001).

CONCLUSIONS

The Greek version of the OAB-q has shown strong psychometric properties of reliability and validity in our study. Urgency incontinence and especially nocturia seem to affect the HRQoL of patients with overactive bladder. OAB-q is valid for Greek patients with overactive bladder and can be used for clinical and academic purposes.

Effect of pelvic floor muscle exercise on pelvic floor muscle activity and voiding functions during pregnancy and the postpartum period

AIMS

The aim of this study was to investigate the effects of pelvic floor muscle exercise during pregnancy and the postpartum period on pelvic floor muscle activity and voiding functions.

METHODS

Pregnant women (n = 60) were randomly assigned into two groups (Training [n = 30] and Control [n = 30]) using a computer-based system. Pelvic floor muscle strength was measured using a perineometry device. Urinary symptoms were measured using the Urinary Distress Inventory (UDI-6), Incontinence Impact Questionnaire (IIQ-7), and the Overactive Bladder Questionnaire (OAB-q). Voiding functions were measured using uroflowmetry and 3-day voiding diaries. Measurements were obtained at week 28, weeks 36-38 of pregnancy, and postpartum weeks 6-8.

RESULTS

Pelvic floor muscle strength significantly decreased during the pregnancy (P < 0.001). However, pelvic floor muscle strength improvement was significantly higher in the Training group compared to the Control group (P < 0.001). The UDI-6, IIQ-7, and OAB-q scores did not significantly change during weeks 36-38 of pregnancy in the Training group (P > 0.05). However, UDI-6, coping, concern, and total scores of OAB-q were significantly decreased during weeks 36-38 of pregnancy in the Control group (P < 0.05). The UDI-6 and OAB-q scores were significantly improved during postpartum weeks 6-8 (P < 0.05). Voiding functions were negatively affected in both groups, decreasing during weeks 36-38 of pregnancy and improving during the postpartum period.

CONCLUSIONS

Pregnancy and delivery affect pelvic floor muscle strength, urinary symptoms, quality of life, and voiding functions. Pelvic floor muscle exercises applied during pregnancy and the postpartum period increase pelvic floor muscle strength and prevent deterioration of urinary symptoms and quality of life in pregnancy.

Impact of symptom improvement on patients' bother and quality of life in female patients with overactive bladder treated by solifenacin (SET-Q)

OBJECTIVES

To analyze the relationship between symptom improvement and health-related quality of life in female overactive bladder patients treated with solifenacin.

METHODS

We carried out a prospective, multicenter, open-label study. Eligible patients were treatment-naive female patients with overactive bladder, with an urgency episode at least once a week. Symptoms were quantitatively assessed by the Overactive Bladder Symptom Score, and quality of life by the Overactive Bladder questionnaire. Changes of symptom severity, bother, and quality of life were assessed at baseline and 12 weeks after treatment with solifenacin 5, 7.5 or 10 mg once daily.

RESULTS

Data from 523 patients (mean age 66 years) were analyzed. Solifenacin significantly improved the total Overactive Bladder Symptom Score and also all subscores for the four symptoms (daytime frequency, urgency, night-time frequency and urgency incontinence). Solifenacin also significantly improved the four quality of life subscales, total quality of life and symptom bother scores of the Overactive Bladder questionnaire. The severity of night-time frequency at baseline positively affected the improvement in the quality of life subscale of Sleep, and the severity of daytime frequency at baseline positively affected the improvement of coping and social interaction. Improvement of severity in various symptoms positively affected the improvement of bother and the quality of life subscales.

CONCLUSIONS

Solifenacin provides an overall improvement of bother and quality of life in female overactive bladder patients. Symptom severity before treatment and improvement of symptom severity seem to variably affect this improvement.

Quality of life in patients with overactive bladder: validation and psychometric properties of the Spanish Overactive Bladder Questionnaire-short Form

BACKGROUND

Overactive bladder (OAB) is characterized by the symptoms of urinary urgency or urge incontinence, which appear without a local pathological or metabolic explanation. OAB is defined by symptoms and the evaluation of treatment effectiveness should be based upon patient perceptions. The Overactive Bladder Questionnaire-Short Form (OAB-q SF) is a brief, self-administered patient-reported outcomes tool with two scales assessing symptom bother and health-related quality of life (HR-QOL) in patients with OAB.

OBJECTIVE

This study aimed to adapt the OAB-q SF into Spanish and to estimate its psychometric properties in patients with symptomatic overactive bladder.

METHODS

The Spanish version of the OAB-q SF was administered on two occasions, 3 months apart, to a set of patients of both sexes, over 18 years of age, diagnosed with OAB, scoring ≥8 on the OAB-V8 scale (a self-reported 8-item OAB screening and awareness tool), and able to understand patient-reported-outcome instruments written in Spanish. Patients were recruited consecutively at urology clinics. Feasibility, internal consistency (Cronbach's alpha), test-retest reliability, structure of instrument, criteria and construct validity and responsiveness were examined using classic test theory statistics.

RESULTS

Data from 246 OAB patients (mean age 57.7 years, 76% women, 99% Caucasian, 37% workers and 36% with a primary education) were evaluated. Floor and ceiling effects ranged between 0.8% and 33%, and missing items were below 2%. Cronbach's alphas attained 0.811 and 0.922 for symptom-bother and HR-QOL domains, respectively. These two subscales matched the original structure and explained variances above 50%, which correlated moderately with EQ-5D (EuroQol) [r = -0.28 and r = +0.31, respectively (p < 0.001 in both cases)]. A significant change in OAB-q SF mean domain scores (-23.8; 95% CI -26.3, -21.3; and +17.7; 95% CI 15.4, 20.6; p < 0.001 in both cases; [effect sizes: 1.32 and 0.98]) was observed after 3 months of medical treatment.

CONCLUSION

The Spanish version of the OAB-q SF demonstrated sufficiently strong psychometric properties of reliability, validity and responsiveness to be used in the measurement of OAB symptom severity and HR-QOL.

Psychometric Properties of the Korean Version of the Overactive Bladder Questionnaire (OAB-q) in a Korean Population

Purpose

Psychometric properties of the overactive bladder questionnaire (OAB-q) were recently examined. However, since the cross-cultural adaptation of a non-English version of the OAB-q has never been demonstrated, we evaluated the psychometric properties of a Korean version of the OAB-q in a Korean population with OAB.

Methods

A prospective cohort study involving 116 women with 58 OAB and 58 control subjects was performed and convergent validity was assessed. Total and subscale OAB-q scores of the control and OAB groups were compared to their sensitivity to score changes before and after administering anti-cholinergic medication for 12 weeks. Short form 36 and King's health questionnaire (KHQ) were also used for comparison or correlation.

Results

Assessment of face validity showed that the Korean version of the OAB-q was reasonable with OAB-q subscale scores being significantly different between the control and patient groups. Significant correlation (range, -0.29 to -0.81) was found between the OAB-q scores and KHQ results for the OAB patients. Cronbach's alpha coefficients (range, 0.77 to 0.95) indicated excellent internal consistency and test-retest analysis involving 35 OAB patients showed that each questions as well as subscale scores were reproducible. Each score of OAB-q also showed statistically significant sensitivity to changes following anti-muscarinic treatment for OAB (n=27, P<0.001 except for social, P=0.059).

Conclusions

The Korean version of the OAB-q is a valid and reliable instrument to measure outcomes in Korean patients with OAB.

A prospective observational study of the effects of treatment with extended-release tolterodine on health-related quality of life of patients suffering overactive bladder syndrome in Sweden

OBJECTIVE

Overactive bladder (OAB) is a chronic condition that has a profound impact on health-related quality of life (HRQoL). This study measured changes in bother of OAB symptoms and self-perceived HRQoL over 6 months in patients treated with extended-release (ER) tolterodine in a naturalistic setting.

MATERIAL AND METHODS

This was a prospective, single-cohort observational study of patients diagnosed with OAB, naïve to antimuscarinic treatment and prescribed tolterodine ER for the first time. Patients were asked to complete the Overactive Bladder Questionnaire (OAB-q) containing a symptom bother scale (0-100) and an HRQoL scale (0-100), which measures coping, social interaction, concern and sleep, at baseline and after 3 and 6 months.

RESULTS

In total, 235 patients (211 women and 24 men), with a mean age of 61 years (30-87), were recruited. The numbers of patients who completed the OAB-q were 220 and 169 at 3 and 6 months, respectively. The mean reductions in the symptom bother score from baseline were 19.6 and 19.3 at 3 and 6 months, respectively. Significant improvement (p < 0.0001) was seen in all HRQoL subscale scores. The proportion of responders who met the minimally important difference (change in the score of 10 or more units between baseline and 6 months) was 64% for the symptom bother score and 34-60% for the total HRQoL and subscale scores.

CONCLUSIONS

OAB patients beginning treatment with tolterodine ER reported clinically significant improvement in OAB symptoms and self-perceived HRQoL over the 6 months of this observational study. The rate of discontinuation from treatment was 49%.