Overactive bladder (OAB) is a highly prevalent condition that is undertreated, although some effective interventions are available. Previous research has demonstrated that navigation of care can help guide patients through the OAB clinical pathway, leading to initiation and continuation of third-line treatment options. The present study evaluated the real-world demographics of OAB patients receiving navigated care compared with those who did not. The objective was to describe the real-world demographic and geographic characteristics of OAB patients identified in a large electronic medical records database representing over 90 community-based urology practices stratified by those who received navigated care and those who did not.

A random set of patients with OAB were retrospectively identified using the ninth and tenth revisions of the International Classification of Diseases, Clinical Modification and procedure codes from the Precision Point Specialty Analytics Portal for OAB database. This database contains the electronic medical record data for community-based urology practices in the US that provide care to over 2.4 million OAB patients. Eligible patients were ≥18 years of age, newly diagnosed and treated for OAB between January 1, 2015, and December 31, 2019, and had ≥2 OAB visits at least 30 days apart. Pregnancy, interstitial cystitis or cystitis after radiation treatment, chronic urinary retention, and neurogenic lower urinary tract dysfunction were exclusion criteria. Treatment navigation was identified by assessing whether the practice offered navigated care, whether the patients had been assigned to a navigator list, and if the navigator-initiated care management through notes or action items in the patient’s chart.

A total of 9000 patients were randomly selected from the 190,697 patients who met all study inclusion criteria. Median age at diagnosis was 67 years (IQR 55-75); Overall, 60% (n=5392) of patients were female and 70% (n=6296) were White (Table 1). A greater percentage of women (17.4%) received navigated care compared with men (5.8%). 18.1% of Black patients received navigated care followed by Asian (14.2%) and White (13.0%) patients. Overall, Medicare (n=3847, 42.7%) and private insurance (n=2504, 27.8%) were the most prevalent insurance types. Within the navigated care group, 20.7% of patients on Medicaid received navigated care, 14.6% on Medicare, 11.0% on private insurance, 10.8% on self-pay insurance, and 8.3% on military insurance, indicating that a larger proportion of patients on Medicaid received navigated care compared with other insurance types. While the Atlanta Medicare region 4 had the most overall number of patients in the study (n=2693, 29.9%; Figure), only 10.5% of those patients received navigated care. In Medicare regions 3 (Philadelphia) and 5 (Chicago), 25.2% and 23.5% of the patients received navigated care, respectively, and in Medicare regions 6 (Dallas) and 10 (Seattle), 10.4% and 9.8% of the patients received navigated care, respectively.

These results suggest that a small portion of men and women with OAB receive navigated care. Navigated patients were more often women of a variety of races on Medicaid or Medicare.

There is potential to increase the implementation of navigator-based care for OAB symptom control across all studied demographics.