Adherence, persistence and switch rates for anticholinergic drugs used for overactive bladder in women: data from the Norwegian Prescription Database

Acta Obstet Gynecol Scand. 2013 Oct;92(10):1208-15. doi: 10.1111/aogs.12196. Epub 2013 Jul 11.


Objective: To investigate the pattern of use of anticholinergic drugs for overactive bladder among women in Norway with regard to persistence, adherence and switch rates.

Design: Observational study.

Setting and sample: Data from the Norwegian Prescription Database on prescriptions for tolterodine, solifenacin, darifenacin and fesoterodine filled in Norwegian pharmacies from 1 January 2004 to 31 December 2010.

Methods and main outcome measures: Data from the database were analysed at an individual level, and drug persistence, discontinuation rates and switch rates during a follow-up period of 365 days after the first prescription were calculated.

Results: Overall 1-year persistence for new users was 38.0%. Within the same period, a total of 10.3% switched from the index drug to another drug in the same group, whereas 51.7% discontinued without switching. Users of solifenacin and tolterodine were somewhat more persistent than users of darifenacin and fesoterodine. Persistence was lowest (20.9%) in the age group 18-39 years, increased with age and was highest in the age groups 70-79 years and 80 years and above (43.5 and 43.3%, respectively). In total, 31.9% filled only one prescription of the drug and, of these, only one of four women switched to another drug. The proportion who were adherent during treatment was 60.4%.

Conclusions: The discontinuation rate for anticholinergic drugs for overactive bladder in women is high. The reasons why patients stop using them remain obscure but could be related both to a limited clinical effect and an unacceptable adverse effect burden.

Keywords: Adherence; anticholinergic drugs; epidemiology; overactive bladder; persistence.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Benzhydryl Compounds / therapeutic use
  • Benzofurans / therapeutic use
  • Cholinergic Antagonists / therapeutic use*
  • Cresols / therapeutic use
  • Databases, Pharmaceutical
  • Drug Substitution / statistics & numerical data*
  • Female
  • Follow-Up Studies
  • Humans
  • Medication Adherence / statistics & numerical data*
  • Middle Aged
  • Norway
  • Phenylpropanolamine / therapeutic use
  • Pyrrolidines / therapeutic use
  • Quinuclidines / therapeutic use
  • Solifenacin Succinate
  • Tetrahydroisoquinolines / therapeutic use
  • Tolterodine Tartrate
  • Urinary Bladder, Overactive / drug therapy*
  • Young Adult


  • Benzhydryl Compounds
  • Benzofurans
  • Cholinergic Antagonists
  • Cresols
  • Pyrrolidines
  • Quinuclidines
  • Tetrahydroisoquinolines
  • Phenylpropanolamine
  • Tolterodine Tartrate
  • fesoterodine
  • darifenacin
  • Solifenacin Succinate