Botox injections for bladder control in nursing home residents: Outcomes and predictors

What is it about?

This study examines the effectiveness and complications of intradetrusor onabotulinumtoxinA injections in nursing home residents with overactive bladder (OAB). The research involved 1,683 residents with a mean age of 78.2 years. Within one year, 34.3% of residents received repeat injections, with rates increasing to 48% by three years for those with longer follow-up. Female residents and those with baseline catheters were more likely to have repeat injections. Complications occurred in 38.4% of residents within 30 days, and 14.6% required new catheters at 3 months. The study concludes that onabotulinumtoxinA injections can be an appropriate treatment for select nursing home residents with OAB, as success rates were comparable to younger adults and independent of frailty and comorbidity.

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Why is it important?

This research is significant because it investigates the effectiveness and safety of intradetrusor onabotulinumtoxinA injections in nursing home residents, a particularly vulnerable and understudied population. Understanding the outcomes of this treatment in frail, elderly individuals can help guide clinical decision-making and improve quality of life for this demographic. The study's findings contribute to the growing body of evidence supporting the use of onabotulinumtoxinA injections as a viable treatment option for overactive bladder (OAB) in older adults, potentially reducing the need for systemic medications that may have adverse effects in this population. Key Takeaways: 1. Treatment Efficacy: The study shows that 34% of nursing home residents underwent repeat onabotulinumtoxinA injections within one year, with rates increasing to 48% by three years, suggesting comparable effectiveness to younger populations despite advanced age and frailty. 2. Safety Profile: Complication rates in this elderly cohort were similar to those observed in younger populations, indicating that the treatment remains relatively safe even in frail, comorbid individuals. 3. Patient Selection: The research emphasizes the importance of considering the entire clinical picture when evaluating nursing home residents for onabotulinumtoxinA injections, rather than excluding patients based solely on age, frailty, or comorbidities.