We propose to foster the applicant's transition to aging research by combining the analytic, clinical and mentoring capabilities of our group. The proposed research will explore care delivery for older men and women with overactive bladder, with or without urinary incontinence. The results of the proposed investigation will potentially reduce health care disparities, identify opportunities to improve quality of care, and foster a paradigm shift in care delivery by informing design of coordinated care models. The overall aims of this project are: 1) to describe patient- and provider- level variation in pharmacologic intervention for older adults with overactive bladder symptoms;and, 2) to empirically identify patient and provider factors associated with treatment intensity, controlling for important clinica covariates such as incontinence.
Overactive bladder disproportionately affects older adults, with a prevalence reaching as high as 50% among those aged at least 76 years;at its most severe, the symptom complex includes urge urinary incontinence, characterized by unpredictable, embarrassing, large-volume urine loss. National costs for treating patients with overactive bladder symptoms are projected to exceed $82 billion by 2020. The project's proposed examination of variation in prescribing patterns and treatment intensity for overactive bladder will broadly inform policy makers and health system leaders interested in reducing health care disparities, improving quality of care, and designing coordinated care models for the treatment of older patients with overactive bladder.