New Insights from AHN’s Pelvic Health Research
A retrospective study from Allegheny Health Network’s (AHN) Women’s Institute, published in the International Urogynecology Journal (DOI: 10.1007/s00192-025-06209-8), reveals a notable pattern in how patients with overactive bladder (OAB) engage with pelvic floor physical therapy (PFPT). The analysis found that OAB patients who were not concurrently prescribed other medications tended to demonstrate higher adherence to PFPT programs compared with those who were taking prescription medicines for related conditions.
What the Study Examined
The study evaluated adherence rates to PFPT among individuals diagnosed with overactive bladder. By focusing on patients with and without concurrent prescription medications, researchers aimed to understand how medication regimens might influence commitment to therapy sessions, home exercise programs, and follow-up visits. The retrospective design allowed investigators to review real-world data from multiple clinical settings within AHN’s network.
Key Findings
While the full data set contains technical details, the central finding is clear: among OAB patients, those not taking additional prescription meds showed higher PFPT adherence. This correlation persisted even after adjusting for several potential confounders, suggesting a meaningful relationship between medication burden and motivation or capacity to participate in non-pharmacologic therapies.
Why Adherence Matters
Pelvic floor physical therapy is a core non-drug approach for managing OAB symptoms, including urgency, frequency, and in some cases, incontinence. Adherence to PFPT often translates to better symptom control, reduced need for invasive procedures, and improved quality of life. These benefits are particularly relevant for patients who prefer or require non-pharmacologic treatment options due to side effects, interactions, or personal preferences regarding medications.
Possible Explanations for the Adherence Pattern
Several interpretations might explain why PFPT adherence appears higher in patients not on prescription meds. For some, avoiding additional medications reduces perceived treatment complexity and cognitive load, making it easier to follow therapy regimens. Others may have milder symptom profiles where lifestyle and PT strategies yield noticeable improvements without pharmacologic intervention. Conversely, patients on multiple meds might experience higher symptom severity or competing health demands that impede consistent PT participation.
Clinical Implications
For clinicians, these findings highlight the importance of individualized care plans. When PFPT is recommended for OAB, providers could consider screening for factors that affect adherence, such as concurrent medication burden, transportation barriers, and competing health priorities. Interventions to simplify regimens, improve appointment access, or tailor home-exercise instructions could help improve PFPT engagement for all patients, including those on prescription therapies.
Future Directions
The study’s retrospective nature provides valuable real-world insights but also invites further prospective research. Future work might explore targeted strategies to boost PFPT adherence across medication groups, examine long-term outcomes, and identify patient subgroups most likely to benefit from combined PFPT and pharmacologic approaches. Collaboration across AHN’s Women’s Institute and urogynecology teams could yield practical protocols to optimize adherence and overall symptom management for OAB.
About AHN and the Women’s Institute
Allegheny Health Network’s Women’s Institute is dedicated to advancing women’s health through comprehensive clinical care, research, and patient education. This study reflects AHN’s commitment to translating clinical data into actionable strategies that improve patient adherence and outcomes in pelvic floor therapy.
References
International Urogynecology Journal, DOI: 10.1007/s00192-025-06209-8
