Most people understand the value of proper maintenance. Homes, cars, and just about anything else worth keeping for a long time require some kind of maintenance to stay in tip-top condition. The same holds true in the treatment of chronic conditions like Overactive Bladder (OAB). Because symptoms are being treated, not cured, ongoing therapy is necessary.
Most patients who successfully complete the initial 12-week Urgent PC protocol will need a treatment about once a month. Most patients who have not tolerated drug therapy are usually up for it. After all, it’s monthly treatment with few, if any, side-effects vs. an OAB drug with daily side-effects.
Incorporating Maintenance Treatment into your Practice
While monthly maintenance treatments are typical, there is no standard interval that meets the needs of all patients. For some patients, treatments may be needed more or less frequently.
A typical approach to incorporating maintenance treatments is to schedule a follow-up appointment 1 month following the initial series and adjust the frequency of treatment as needed. For example, if symptoms began to reoccur at that appointment, schedule the next treatment 3 weeks out. But if the patient was able to maintain their results, push the next treatment 5 weeks out. In addition, many practices have taken efforts to be flexible with patients to accommodate Urgent PC treatments when they start to feel the urge again.
With older adults, enlisting the help of a spouse, friend, family member, or caregiver to reinforce treatment rules will help patients stay in compliance. Often behavioral changes can be made that will impact their success, such as establishing normal voiding intervals, eliminating bladder irritants from the diet, managing intake of fluids, controlling weight gain, establishing regular bowel movements, and quitting smoking.
Results of Clinical Trials
Clinical trials have outlined approaches to establishing interval treatments. In one 12-week study, PTNS demonstrated excellent durability through 12 months of follow-up, with 94% sustained improvement from 12 weeks. Subjects in the study received an average of 1.2 treatments monthly to sustain symptom improvement throughout 12 months.
In the STEP study (Sustained Therapeutic Effects of Percutaneous Tibial Nerve Stimulation), patients were prescribed a fixed schedule 14-week tapering protocol followed by a personal treatment plan aimed at sustaining overactive bladder symptom improvement. Overactive bladder and quality of life questionnaires were completed every three months, and 3-day voiding diaries were completed every six months.
In addition, a review of medical records from a university urogynecology practice showed that 77.5% of patients continued long-term treatment (4 – 103 months) with a treatment interval of 1-3 months.
Most insurance companies recognize the need for maintenance therapy for OAB. Maintenance therapy for PTNS is typically covered by insurance companies for up to three years, but it is the provider’s responsibility to check with their insurance company to see what’s covered for each patient. More about Urgent PC Reimbursement.
All documentation is done neatly and proficiently on the forms provided by Cogentix Medical. They take just minutes to complete, and comply with all necessary information needed to abide by third-party payer requests for billing. As an added benefit, these documents also give the clinician a bird’s-eye view of their patients’ progress.
Ensuring Long-Term Success
Communication and flexibility are key for patient success with Urgent PC. In addition, putting some of control on the patient’s shoulders can improve results and help manage expectations.
Urgent PC is indicated for the treatment of Overactive Bladder and associated symptoms of urinary urgency, urinary frequency and urge incontinence. Treatment with Urgent PC is contraindicated for patients with pacemakers or implantable defibrillators, patients prone to excessive bleeding, patients with nerve damage that could impact either percutaneous tibial nerve or pelvic floor function or patients who are pregnant or planning to become pregnant during the duration of the treatment. Most patients don't experience side-effects. If side-effects occur, they are typically temporary and include mild pain and skin inflammation at or near the stimulation site. Caution: Federal law (USA) restricts this device to sale by or on the order of a physician. For complete instructions for use, storage, warnings, indications, contraindications, precautions, adverse reactions and disclaimer of warranties, please refer to the insert accompanying each product or online at www.cogentixmedical.com. Urgent PC is a registered trademark of Cogentix Medical © 2016 Cogentix Medical. All rights reserved.