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Patient-centered communication and shared decision-making may improve engagement and satisfaction in overactive bladder treatmentWomen face heavy burdens when seeking treatment for overactive bladder

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Key Takeaway
Note that patient-centered communication and shared decision-making may improve engagement and satisfaction in OAB.

This systematic review and meta-synthesis explores the experiences and perceptions of women, caregivers, and healthcare professionals regarding overactive bladder (OAB) treatment. The scope of the synthesis focuses on the qualitative experiences of managing the condition rather than clinical outcomes.

The synthesis identified five primary themes: (1) the burden of treatment versus the burden of illness, (2) the erosion of trust in the therapeutic alliance, (3) a knowledge gap and desire for agency, (4) psychosocial barriers to treatment engagement, and (5) a preference for low-burden treatments and resistance to behavioral change. These findings highlight significant barriers to adherence and the importance of the patient-provider relationship.

Clinical implications suggest that patient-centered communication, shared decision-making, and individualized support may improve treatment engagement, satisfaction, and adherence. While the synthesis provides qualitative insights into the patient experience, it is important to note that these results are based on perceptions and experiences rather than clinical trial data. The GRADE-CERQual assessment was performed to evaluate confidence in the synthesized qualitative findings.

How this fits prior evidence

This meta-synthesis addresses a gap in understanding the patient experience and psychosocial barriers to overactive bladder management. While previous evidence has established the efficacy of pharmacological combinations like solifenacin and mirabegron, and interventions such as auricular thumbtack needle therapy or TTNS plus behavior therapy, this synthesis highlights the importance of the therapeutic alliance and patient agency. It complements existing clinical data by identifying why patients may resist behavioral changes or experience a burden of treatment.

Living with an overactive bladder can be exhausting, but the journey to find relief often comes with its own set of hurdles. New research highlights that many women feel overwhelmed by the demands of treatment. They often find the effort required to manage the condition almost as taxing as the symptoms themselves.

The study identified several key barriers, including a significant gap in knowledge and a desire for more personal agency. When patients feel they lack information, it can damage the trust they have with their healthcare providers. This breakdown in the relationship makes it harder for women to feel supported or confident in their treatment plans.

Many women expressed a clear preference for low-burden treatments and showed resistance to making big lifestyle changes. To improve results, the findings suggest that doctors should focus on better communication and shared decision-making. By providing individualized support, healthcare teams can help patients feel more in control and more likely to stick with their treatment.

What this means for you:
Better communication and less demanding treatment options can help women manage overactive bladder more effectively.

Common questions

What makes it hard for women to stick with overactive bladder treatment?

Many women find the burden of treatment to be nearly as difficult as the illness itself. They often face psychosocial barriers and a lack of information, which can make it hard to stay engaged. Additionally, many women prefer low-burden treatments and may resist changes that require significant effort or behavioral shifts.

How does the relationship with a doctor affect treatment?

A gap in knowledge can lead to a loss of trust between the patient and the healthcare provider. When patients feel they lack information or agency, it can damage the therapeutic alliance. Improving communication and using shared decision-making can help rebuild this trust and improve how patients experience their care.

What kind of support helps patients with overactive bladder?

The findings suggest that patient-centered communication and individualized support are key. When doctors focus on the specific needs of the patient and involve them in the decision-making process, it can lead to better satisfaction and help patients stay committed to their treatment plans.

Study Details

Study typeMeta analysis
EvidenceLevel 1
PublishedOct 2026
View Original Abstract ↓
Overactive bladder (OAB) is a common condition that substantially impairs quality of life yet remains underreported and undertreated. Understanding how women, caregivers, and healthcare professionals (HCPs) perceive OAB treatments may help improve patient-centered care. This systematic review and meta-synthesis aims to synthesize qualitative evidence on experiences and perceptions of OAB treatment. MEDLINE, Scopus, Google Scholar and CINAHL were searched from inception to January 2026 for qualitative studies exploring treatment experiences among women with OAB, their caregivers, and HCPs. Three reviewers independently screened studies, extracted data, and performed line-by-line coding. Data were synthesized using thematic synthesis. Methodological quality was assessed using the Critical Appraisal Skills Programme (CASP) checklist. A GRADE-CERQual assessment was performed to evaluate confidence in the synthesized qualitative findings. Thirteen qualitative studies were included. Forty-five codes were identified and synthesized into five analytical themes: (1) the burden of treatment vs. the burden of illness, reflecting the tension between symptom burden and treatment-related challenges; (2) erosion of trust in the therapeutic alliance, driven by poor communication and unmet expectations; (3) the knowledge gap and desire for agency, highlighting unmet informational needs and preferences for shared decision-making; (4) psychosocial barriers to treatment engagement, encompassing stigma, embarrassment, isolation, and emotional distress; and (5) preference for low-burden treatments and resistance to behavioural change, reflecting preferences for convenient therapies and difficulties sustaining long-term behavioural interventions. Experiences of OAB treatment extend beyond symptom control and are shaped by psychosocial burden, healthcare interactions, treatment expectations, and the need for autonomy. Patient-centered communication, shared decision-making, and individualized support may improve treatment engagement, satisfaction, and adherence. https://www.crd.york.ac.uk/PROSPERO/view/CRD420261289760, Identifier: CRD420261289760.
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