Prevalence, Risk Factors, and Treatment for Overactive Bladder in a Racially Diverse Population

Objective: To evaluate differences in prevalence, overactive bladder (OAB) risk factors, and OAB treatment in a diverse population of underrepresented racial/ethnic groups. Methods: This is a retrospective cohort study of women ≥ 18 years who had an OAB diagnosis code from June 1, 2013 to June 30, 2016. Women who had neurogenic bladder or pelvic cancer were excluded. OAB risk factors included age, body mass index, socioeconomic status, diabetes, and smoking. OAB treatment included consultation with a specialist, diagnostic testing, medication, and third-line therapy (neuromodulation or chemodennervation). ANOVA and Chi-square were used to compare continuous and categorical variables. Multivariable logistic regression models were developed to examine the association between racial/ethnic groups and OAB management while controlling for risk factors. Results: OAB prevalence was 4.41% (5407/122,606) and was highest in Hispanic women. Black and Hispanic women were significantly younger, had a higher median body mass index, higher rate of diabetes, and lower socioeconomic status compared to White women. There was no racial difference in OAB prescriptions. Black women were less likely to consult with a specialist in multivariable analysis. Conclusion: OAB prevalence and presence of OAB risk factors was highest in Hispanic and Black women. Black women were less likely to consult with a specialist suggesting that Black women receive initial therapy from primary care physicians. Future studies will evaluate if racial differences in OAB treatment are due to patient preference or provider practices.