Warning Time, Urgency Severity, and Patient-Reported Outcomes: Important Metrics in Understanding Urgency

Release Date: July 2007
Expiration Date: July 31, 2008

Faculty

The International Continence Society definition of urgency describes urgency as the central symptom of over active bladder, although difficulties exist in defining as well as quantifying it. To complicate matters, little is known about the pathophysiology of urgency although recently more attention has been paid on urothelial-afferent communication and its possible impact on pharmacotherapy for OAB.

OAB studies in the past have not focused on urgency; instead, they have investigated it as a secondary parameter or have not measured it at all. Frequency and urge incontinence, the usual choices for primary endpoints, are easier to quantify and do not rely as much on patient-derived judgment.

A variety of generic and disease-specific outcome measures have emerged to assess symptom bother, patient-satisfaction as well as the urgency component of the overactive bladder patient, including the newer concept of warning time.

This journal club activity will review the latest study design and clinical trial data in urgency and how they can translate into meaningful outcomes for patients.

This activity will consist of didactic lectures and panel discussions supported by slides posted on the web.

• Read the objectives and other introductory information.
  
• Listen to the audio while viewing the slides; Please note that this program was recorded, and as a result, participants will not have the opportunity to ask questions of the presenter.
• Take the post-test.
• Complete the evaluation and registration information.
• Participants who complete the post-test and evaluation will be issued a CME certificate, which may be printed at their location. A database of certificates awarded online is maintained at the Dannemiller Foundation. No additional certificate will be mailed. If you have any questions, you may contact the Dannemiller Foundation at editor@dannemiller.com. Expiration date for credit is July 31, 2008.
• This activity should take about 1 hour to complete.

• Describe the pathophysiology of urinary urgency and the challenge to assess this parameter in the urologic patient with OAB
• Discuss warning time, urgency severity, and patient-reported outcomes as metrics for urgency

This activity has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education through the joint sponsorship of The Dannemiller Memorial Educational Foundation and The Customer Link, Inc. The Dannemiller Memorial Educational Foundation is accredited by the ACCME to provide continuing medical education for physicians.

The Dannemiller Memorial Educational Foundation designates this educational activity for a maximum of 1 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

This activity is designed for urologists and primary care physicians with a special interest in urology.

In accordance with the Accreditation Council for Continuing Medication Education (ACCME), the Dannemiller Memorial Educational Foundation requires that any person who is in a position to control the content of a CME activity must disclose all relevant financial relationships they have with a commercial interest. Accordingly:

Dr. Staskin reported that he serves as a consultant and speaker for Astellas Pharma US, Inc.; Esprit Pharma, Inc; Pfizer, Inc.; and Watson Pharmaceuticals, Inc. He also receives grant/research support from Esprit Pharma and Watson Pharmaceuticals, Inc.

Dr. Zinner reported that he serves as an investigator, consultant, and speaker for and receives grant/research support from Esprit Pharma, Inc. He also serves as an investigator and speaker for Astellas Pharma US, Inc. and Watson Pharmaceuticals, Inc.; and an investigator for Novartis AG.

Elke Graser, medical writer, has no financial relationships with any commercial interests that are relevant to this activity to disclose.

The Dannemiller Memorial Educational Foundation staff that was involved in the development of this activity have no financial relationships with any commercial interests that are relevant to this activity. All staff of The Customer Link, Inc. involved in the development of this activity have no financial relationships to disclose.

To resolve identified conflicts of interest, the educational content was fully peer-reviewed by a physician member of the Dannemiller Clinical Content Review Committee who has nothing to disclose. The resulting certified activity was found to provide educational content that is current, evidence-based, and commercially balanced.

This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. The opinions expressed in the educational activity are those of the faculty. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings. Further, attendees/participants should appraise the information presented critically and are encouraged to consult appropriate resources for any product or device mentioned in this program.

The content and views presented in this educational activity are those of the authors and do not necessarily reflect those of the Dannemiller Memorial Educational Foundation, Astellas Pharma US, Inc., or The Customer Link, Inc. This material is prepared based upon a review of multiple sources of information, but it is not exhaustive of the subject matter. Therefore, healthcare professionals and other individuals should review and consider other publications and materials on the subject matter before relying solely upon the information contained within this educational activity.