Coping strategies and health care-seeking behavior in a US national sampleof adults with symptoms suggestive of overactive bladder

Background. Although millions of individuals have symptoms suggestive of ov eractive bladder (OAB), few ever seek or receive medical treatment for thei r condition. Objective: The purpose of this study was to describe coping strategies and health care-seeking behavior in a community-based sample of adults with sym ptoms suggestive of OAB. Methods: A cross-sectional household telephone survey of an age- and sex-st ratified sample of adults was conducted. The survey consisted of general he alth-related questions as well as questions related to OAB symptoms. A tota l of 4896 adults completed the interview. Respondents were considered to ha ve OAB if they reported greater than or equal tol symptom of urinary urgenc y, frequency, or urge incontinence. A follow-up questionnaire was then mail ed to a subsample of the telephone interview respondents. The mailed questi onnaire contained questions related to type and severity of OAB symptoms, c oping strategies, medical care/treatment, feelings/beliefs about OAB, and q uality of life. Half of the phone respondents with urinary incontinence (n = 638) and a random sample of all other phone respondents received the mail ed questionnaire (n = 873); 1034 questionnaires were returned. Results: Of the respondents with OAB, 69.6% tried greater than or equal to1 nonmedical coping strategy. Respondents with incontinent OAB were signific antly more likely than those with continent OAB or those with no OAB (contr ols) to use nonmedical coping strategies (incontinent OAB, 76.1%; continent OAB, 59.0%; controls, 31.9%, P < 0.001). Fewer than half of the respondent s with OAB (43.5%) had spoken with a provider about OAB in the previous 12 months. Medical consultation was associated with sex., type and severity of OAB, number of nonmedical coping strategies tried, number of OAB informati on sources consulted, inclination to try new OAB medications. and feelings/ beliefs about OAB. In 90% of patient-provider discussions about OAB. the pa tient initiated the topic. Conclusions: Individuals manage symptoms suggestive of OAB primarily by usi ng nonmedical coping strategies rather than consulting health care provider s. Results of this study support the need for improved clinical recognition of OAB and increased patient-provider communication about this condition.