{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T19:21:34Z","timestamp":1774380094950,"version":"3.50.1"},"reference-count":9,"publisher":"American Society of Consultant Pharmacists","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["sr care pharm"],"published-print":{"date-parts":[[2025,4,1]]},"abstract":"<jats:p><jats:bold>Background<\/jats:bold> Urinary incontinence is a condition prevalent in older adults and has the potential to impact health and quality of life in patients. Commonly prescribed anticholinergic medications have significant side effects that are often heightened in older adults and should\n be optimized and de-escalated as warranted. Given pharmacists\u2019 focus on medication regimens, pharmacists are uniquely equipped to help optimize overactive bladder (OAB) medications in long-term care.  <jats:bold>Objective<\/jats:bold> To reduce inappropriate use of OAB medications in older\n adults residing within long-term care facilities.  <jats:bold>Methods<\/jats:bold> An intervention-based quality improvement project was completed including 27 patients who were residing at multiple care settings within the long-term care facilities studied. A medication review and patient interview\n were conducted by a clinical pharmacist to assess OAB medication appropriateness. Recommendations for therapy modification were made to the medical team to reduce anticholinergic adverse effects while maintaining treatment effect.  <jats:bold>Results<\/jats:bold> A total of eight patients (57.1%)\n in the intervention group reported experiencing lessened or eliminated anticholinergic adverse effects compared with only one patient (10%) reporting the same in the non-intervention group (<jats:italic>P<\/jats:italic> = 0.0333; OR [95% CI] = 10.7 [1.007-587.8]). Effects of intervention on OAB symptoms were variable\n but most patients did not experience worsening of symptoms. A total of 14 OAB medications were deprescribed or dose-reduced.  <jats:bold>Conclusion<\/jats:bold> Pharmacist optimization of OAB medications for older individuals residing in longterm care facilities is associated with elimination of\n potentially unnecessary medications, potentially with improvement of adverse effects and without worsening of the OAB symptoms.<\/jats:p>","DOI":"10.4140\/tcp.n.2025.177","type":"journal-article","created":{"date-parts":[[2025,3,26]],"date-time":"2025-03-26T04:36:22Z","timestamp":1742963782000},"page":"177-184","source":"Crossref","is-referenced-by-count":1,"title":["Optimization of Overactive Bladder Medications in Older Adults Residing in Long-Term Care Facilities"],"prefix":"10.4140","volume":"40","author":[{"given":"Ashley","family":"Strong","sequence":"first","affiliation":[{"name":"Clinical Pharmacist, LECOM Health, Erie, Pennsylvania."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eric","family":"Steele","sequence":"additional","affiliation":[{"name":"Clinical Pharmacist, LECOM Health, Erie, Pennsylvania."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2625","reference":[{"issue":"7","key":"ref1","doi-asserted-by":"crossref","first-page":"1132","DOI":"10.1111\/j.1464-410X.2010.09993.x","article-title":"Worldwide prevalence estimates of lower urinary tract symptoms, overactive bladder, urinary incontinence and bladder outlet obstruction.","volume":"108","year":"2011","journal-title":"BJU Int."},{"issue":"36","key":"ref2","first-page":"1","article-title":"Prevalence of incontinence among older Americans.","year":"2014","journal-title":"Vital Health Stat 3."},{"issue":"3","key":"ref3","doi-asserted-by":"crossref","first-page":"411","DOI":"10.1001\/jamainternmed.2019.6398","article-title":"Effectiveness of combined behavioral and drug therapy for overactive bladder symptoms in men: a randomized clinical trial.","volume":"180","year":"2020","journal-title":"JAMA Intern Med."},{"issue":"7","key":"ref4","doi-asserted-by":"crossref","first-page":"465","DOI":"10.7326\/M18-3227","article-title":"Pharmacologic and nonpharmacologic treatments for urinary incontinence in women: a systematic review and network meta-analysis of clinical outcomes.","volume":"170","year":"2019","journal-title":"Ann Intern Med."},{"issue":"3","key":"ref5","doi-asserted-by":"crossref","first-page":"401","DOI":"10.1001\/jamainternmed.2014.7663","article-title":"Cumulative use of strong anticholinergics and incident dementia: a prospective cohort study.","volume":"175","year":"2015","journal-title":"JAMA Intern Med."},{"issue":"3","key":"ref6","doi-asserted-by":"crossref","first-page":"196","DOI":"10.1111\/iju.13498","article-title":"Systematic review and meta-analysis on the efficacy and tolerability of mirabegron for the treatment of storage lower urinary tract symptoms\/overactive bladder: comparison with placebo and tolterodine.","volume":"25","year":"2018","journal-title":"Int J Urol."},{"issue":"8","key":"ref7","doi-asserted-by":"crossref","first-page":"e0255642","DOI":"10.1371\/journal.pone.0255642","article-title":"Polypharmacy prevalence in older adults seen in United States physician offices from 2009 to 2016.","volume":"16","journal-title":"PLoS One."},{"issue":"6","key":"ref8","article-title":"Prevalence and factors associated with polypharmacy in long-term care facilities: a systematic review.","volume":"16","year":"2015","journal-title":"J Am Med Dir Assoc."},{"issue":"11","key":"ref9","doi-asserted-by":"crossref","first-page":"3230","DOI":"10.1111\/jgs.17965","article-title":"Pharmacist-driven interventions to de-escalate urinary antimuscarinics in the Programs of All-Inclusive Care for the Elderly.","volume":"70","year":"2022","journal-title":"J Am Geriatr Soc."}],"container-title":["The Senior Care Pharmacist"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ingentaconnect.com\/content\/ascp\/tscp\/2025\/00000040\/00000004\/art00004","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,3,28]],"date-time":"2025-03-28T04:33:50Z","timestamp":1743136430000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ingentaconnect.com\/content\/10.4140\/TCP.n.2025.177"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4,1]]},"references-count":9,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2025,4,1]]}},"alternative-id":["2639-9636(20250401)40:4L.177;1-"],"URL":"https:\/\/doi.org\/10.4140\/tcp.n.2025.177","relation":{},"ISSN":["2639-9636"],"issn-type":[{"value":"2639-9636","type":"print"}],"subject":[],"published":{"date-parts":[[2025,4,1]]}}}