Patients with overactive bladder stick with pelvic-floor therapy more when they aren’t taking other prescription meds, AHN study finds

More patients completed pelvic-floor physical therapy when they weren’t on other bladder drugs

Researchers at Allegheny Health Network (AHN) reported a clear pattern: people seeking pelvic-floor physical therapy for overactive bladder were more likely to keep going with therapy if they were not also taking prescription bladder medications. The finding comes from a large look back through clinical records and insurance claims, and it suggests how treatment choices outside the doctor’s office can shape whether patients stick with a non-drug option.

How the team looked at real-world care — who was included and what was measured

The study used a retrospective design, meaning researchers examined past records rather than enrolling patients into a new trial. They combined electronic health records and billing data to identify adults diagnosed with overactive bladder who were prescribed or referred for pelvic-floor physical therapy over a multi-year period.

Patients were split into two groups: those who were taking a prescription medication for bladder symptoms around the time they started therapy, and those who were not. The team tracked attendance at therapy visits and whether patients completed a recommended course of treatment. They also recorded basic patient details such as age, sex, and whether patients had other common health problems that can affect bladder control.

The investigators used standard, practical measures of adherence — for example, attending a minimum number of sessions within a typical treatment window — rather than experimental or patient-reported adherence scales. This keeps the results grounded in how clinics and insurers see therapy use day to day.

What the numbers show: clearer patterns in attendance and completion

Across the sample, the study found a meaningful difference in how patients engaged with pelvic-floor therapy depending on whether they were also taking bladder medications. People not on concurrent prescription drugs were more likely to both start treatment and complete the usual course of sessions. In plain terms: if a patient was managing symptoms with only non-drug approaches, they tended to follow through with the therapy program more often than someone juggling pills and physical therapy.

The gap appeared in both attendance and completion rates, and it persisted after the researchers adjusted for simple differences like age and common medical conditions. That suggests the pattern is not just because one group was healthier or younger. The team also reported that patients who combined therapy with drugs tended to drop out sooner and attend fewer sessions overall.

Importantly, the study did not claim that pelvic-floor therapy is more effective when used alone. Instead, the data describe behavior — who shows up and who keeps going — rather than comparing how well the treatments work head-to-head.

Why this matters for patients and how care is delivered

For people living with overactive bladder, adherence to pelvic-floor therapy matters because the therapy requires multiple sessions and practice to work. If patients are less likely to keep attending when they are also taking medication, clinics may need to rethink how they present combined treatment plans.

From a practical standpoint, the study suggests clinicians should ask about concurrent treatment right away and set clear expectations. Patients who are trying both approaches might benefit from extra scheduling supports, reminders, or brief check-ins to keep them engaged with therapy. The research highlights that the logistics of care — not only medical advice — shape outcomes.

How experts see the result and how it fits with earlier work

Clinicians who treat bladder problems have long observed that patients mix strategies in different ways. This study gives those observations quantitative backing by showing a consistent difference in real-world behavior. Some specialists say the finding lines up with the idea that when patients rely on quick-solution medications, they may deprioritize time-consuming therapies.

Others note the study helps explain why trials and real-world results sometimes diverge: a therapy can work in tightly run studies where attendance is enforced, yet underperform in everyday care where patients juggle time, cost and competing treatments. The AHN data add to a growing literature that looks at how treatment pathways unfold outside clinical trials.

Limitations and what researchers should look at next

The study’s retrospective design limits what it can prove. It shows a link between medication use and therapy adherence but cannot prove one causes the other. The data also lack some personal details — for example, why patients stopped attending, their symptom severity, or whether costs or travel barriers played a role.

Next steps include prospective studies that follow patients from the moment treatment decisions are made, and trials that test interventions to keep people engaged when they use both therapy and drugs. For now, the AHN work shines a light on a simple but important fact: how treatments are combined in the real world affects whether patients get the full benefit of care.

Sources

• prnewswire.com