(1206) Examining the Impact of Loop Diuretic-induced Overactive Bladder on Quality of Life in Heart Failure Patients: Physician and Patient Perspectives

Objectives: Loop diuretics are commonly used and strongly recommended by ACC/AHA guidelines in patients with chronic congestive heart failure (HF) to alleviate signs and symptoms of fluid overload. Studies have shown that the use of loop diuretics reduces mortality in patients with HF compared to a placebo. While they help relieve congestive symptoms and reduce mortality, they may also have potential bladder side effects, such as increased urinary frequency and urgency, and urgency incontinence. The relationship between diuretic use and bladder side effects has not been well studied. Further, there is limited research assessing prescriber habits in managing overactive bladder (OAB), especially in patients with HF who are on loop diuretics.

This study will examine the impact of loop diuretics on urinary side effects and quality of life in HF patients by 1) investigating the association between loop diuretic use and bladder symptoms; 2) examining how patients manage their worsening bladder problems, and 3) identifying prescribing habits in physicians managing patients with HF who are on loop diuretics and report OAB as a side effect.

Methods: This IRB-approved prospective study will employ a cross-section survey design. The patient sample will have two groups: 1) a control group, consisting of English-speaking patients aged ≥55 years with a diagnosis of OAB; and 2) an intervention group, comprising patients aged ≥55 years diagnosed with HF who are currently using a loop diuretic and experiencing symptoms of overactive bladder. Recruitment and electronic survey administration will be conducted using a patient panel by All Global, Inc., a health research company.

Patient surveys include a total of 31 questions related to patient medical history, overactive bladder symptoms, quality of life, OAB management strategies, and patient characteristics (gender, race/ethnicity, education level, health insurance, annual income, health conditions, and number of prescription medications). The intervention group will complete 4 additional questions related to medication use.

Physicians managing patients with HF will be drawn from a pre-existing database. The physician survey will comprise 9 questions, focusing on physician characteristics and their management of patients with HF who are on loop diuretics and report symptoms of overactive bladder. All surveys will be distributed to the participants using Quartics links.

Based on the Raosoft sample size calculator, which considered an estimated population of 3.5 million HF patients suffering from OAB, a 95% confidence level, and a 5% margin of error, we will require a minimum of 385 patients for this study. To account for attrition, we will recruit at least 250 patients for the intervention group and 250 for the control group.

This estimated sample size for physicians is 224, calculated using the Raosoft sample size calculator with a database of 1000 physicians, and we anticipated a 25% response rate with a 95% confidence level and a 5% margin of error. To account for attrition, 250 physicians will be recruited for the physician surveys.

Results: Face and content validation is currently being conducted. Descriptive analysis will be performed on the survey responses, and the results of the data will be reported in aggregate. The analysis will include a comparison of responses from control and intervention groups, and correlations with participant characteristics and medication history. Physician and patient responses will also be compared to assess congruency.

Conclusions: In progress.