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dc.contributor.authorBoyes, Randall
dc.contributor.otherQueen's University (Kingston, Ont.). Theses (Queen's University (Kingston, Ont.))en
dc.date2015-07-30 20:38:24.491en
dc.date.accessioned2015-08-11T23:35:35Z
dc.date.issued2015-08-11
dc.identifier.urihttp://hdl.handle.net/1974/13495
dc.descriptionThesis (Master, Community Health & Epidemiology) -- Queen's University, 2015-07-30 20:38:24.491en
dc.description.abstractOveractive bladder (OAB) and urge urinary incontinence (UUI) are conditions that affect 12 – 18% of Canadians and that grow increasingly common with age. Patterns of use and comparative safety of six anticholinergic medications used to treat OAB and UUI were examined. Two of these medications (oxybutynin, tolterodine) have been included for many years on the provincial drug formulary, while the other four (solifenacin, darifenacin, trospium chloride, fesoterodine) have only recently been listed with conditions as “limited use” (LU) products. Acute urinary retention is a possible adverse outcome associated with these medications and was the outcome selected for the analysis of comparative safety. Participants were patients from Ontario between 66 and 105 years of age who received a new prescription for one of the bladder anticholinergic medications listed on the formulary between December 15, 2011 and December 31, 2013. A retrospective cohort design was used. Patients who were new users of any of the six bladder anticholinergic medications were identified from ODB program data. Descriptive statistics were used to assess physician adherence to the LU criteria. These patients were assigned to groups based on the bladder anticholinergic medication they received and the risk of acute urinary retention in new users of each medication was compared. Cox Proportional Hazards models were used to calculate hazard ratios to compare the risk of acute urinary retention among new users of each of the newer medications as compared to new users of oxybutynin. Analyses were stratified by sex, as men are known to be at greater risk of urinary retention than women. Only 10% of patients met the LU criteria for a prior trial of oxybutynin. Among men (but not women), new use of solifenacin, darifenacin, or tolterodine was associated with a reduced risk of acute urinary retention as compared to oxybutynin. The LU criteria for newer bladder anticholinergic medications do not appear to serve as an effective means of regulating their prescription. Exposure to these medications appears to confer a lower risk of acute urinary retention than oxybutynin in male patients. Further research into other potential adverse effects of these medication is needed.en_US
dc.languageenen
dc.language.isoenen_US
dc.relation.ispartofseriesCanadian thesesen
dc.rightsQueen's University's Thesis/Dissertation Non-Exclusive License for Deposit to QSpace and Library and Archives Canadaen
dc.rightsProQuest PhD and Master's Theses International Dissemination Agreementen
dc.rightsIntellectual Property Guidelines at Queen's Universityen
dc.rightsCopying and Preserving Your Thesisen
dc.rightsThis publication is made available by the authority of the copyright owner solely for the purpose of private study and research and may not be copied or reproduced except as permitted by the copyright laws without written authority from the copyright owner.en
dc.subjectpharmacoepidemiologyen_US
dc.subjectdrug safetyen_US
dc.titlePATTERNS OF USE AND COMPARATIVE SAFETY OF NEW AND OLD ANTICHOLINERGIC MEDICATIONS IN OLDER ADULTS: A POPULATION-BASED STUDYen_US
dc.typeThesisen_US
dc.description.restricted-thesisI would prefer that the thesis not be made public immediately in order to allow time for publication of the results (as others have access to the databases used) and for further work to be done in the area by my supervisor.en
dc.description.degreeMasteren
dc.contributor.supervisorGill, Sudeepen
dc.contributor.supervisorOuellette-Kuntz, Hélèneen
dc.contributor.departmentCommunity Health and Epidemiologyen
dc.embargo.terms1825en
dc.embargo.liftdate2020-08-09


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