Zoe Kopp

Bio: Zoe Kopp is an academic researcher from Pfizer. The author has contributed to research in topics: Overactive bladder & Lower urinary tract symptoms. The author has an hindex of 39, co-authored 95 publications receiving 9263 citations. Previous affiliations of Zoe Kopp include St Thomas' Hospital & University of California, San Francisco.

Worldwide prevalence estimates of lower urinary tract symptoms, overactive bladder, urinary incontinence and bladder outlet obstruction

Abstract: Study Type – Symptom prevalence (prospective cohort) Level of Evidence 1b What’s known on the subject? and What does the study add? Few prevalence studies used current ICS LUTS symptom definitions and to our knowledge no studies exist that estimate total worldwide prevalence of reported LUTS symptoms One of the primary goals of this analysis was to estimate current and future worldwide prevalence of LUTS among adults Our estimation model suggests that LUTS are highly prevalent worldwide, with an increasing burden predicted over time OBJECTIVE • To estimate and predict worldwide and regional prevalence of lower urinary tract symptoms (LUTS), overactive bladder (OAB), urinary incontinence (UI) and LUTS suggestive of bladder outlet obstruction (LUTS/BOO) in 2008, 2013 and 2018 based on current International Continence Society symptom definitions in adults aged ≥20 years PATIENTS AND METHODS • Numbers and prevalence of individuals affected by each condition were calculated with an estimation model using gender- and age-stratified prevalence data from the EPIC study along with gender- and age-stratified worldwide and regional population estimates from the US Census Bureau International Data Base RESULTS • An estimated 452%, 107%, 82% and 215% of the 2008 worldwide population (43 billion) was affected by at least one LUTS, OAB, UI and LUTS/BOO, respectively By 2018, an estimated 23 billion individuals will be affected by at least one LUTS (184% increase), 546 million by OAB (201%), 423 million by UI (216%) and 11 billion by LUTS/BOO (185%) • The regional burden of these conditions is estimated to be greatest in Asia, with numbers of affected individuals expected to increase most in the developing regions of Africa (301–311% increase across conditions, 2008–2018), South America (205–247%) and Asia (197–244%) CONCLUSIONS • This model suggests that LUTS, OAB, UI and LUTS/BOO are highly prevalent conditions worldwide Numbers of affected individuals are projected to increase with time, with the greatest increase in burden anticipated in developing regions • There are important worldwide public-health and clinical management implications to be considered over the next decade to effectively prevent and manage these conditions

The impact of overactive bladder, incontinence and other lower urinary tract symptoms on quality of life, work productivity, sexuality and emotional well-being in men and women: results from the EPIC study.

Abstract: OBJECTIVES To examine the effect overactive bladder (OAB) and other lower urinary tract symptoms (LUTS) on health-related quality of life (HRQoL) in a population sample, as OAB often occurs in conjunction with many other LUTS. SUBJECTS AND METHODS A nested case-control analysis was performed on men and women with (cases) and without (controls) OAB, from the EPIC study. OAB was assessed using 2002 International Continence Society definitions. Based on their responses to questions about LUTS, cases were classified into five groups; continent OAB, OAB with incontinence, OAB + postmicturition, OAB + voiding, and OAB + postmicturition + voiding. Both cases and controls were asked questions about symptom bother (OAB-q), generic QoL (EQ-5D), work productivity (Work Productivity and Activity Impairment, WPAI), depressive symptoms (Center for Epidemiologic Studies Depression Scale), sexual satisfaction, and erectile dysfunction (men only) using the Massachusetts Male Aging Study. Cases answered additional condition-specific questions HRQoL (OAB-q short form), Patient Perception of Bladder Condition and work productivity related to a specific health problem (WPAI-SHP). General linear models were used to evaluate group differences. RESULTS Of the EPIC participants, 1434 identified OAB cases were matched by age, gender and country, with 1434 participants designated as controls. Cases and controls were primarily Caucasian (96.2% and 96.7%, respectively), and most (65%) were female; the mean age was 53.8 and 53.7 years, respectively. Comorbid conditions differed significantly by case/control status, with cases reporting significantly greater rates of chronic constipation, asthma, diabetes, high blood pressure, bladder or prostate cancer, neurological conditions and depression. There were significant differences between the cases and controls in all reported LUTS. The OAB + postmicturition + voiding group reported significantly greater symptom bother, worse HRQoL, higher rates of depression and decreased enjoyment of sexual activity, than the other subgroups. CONCLUSION OAB has a substantial, multidimensional impact on patients; OAB with additional LUTS has a greater impact. The diagnosis and treatment of OAB should be considered in conjunction with other LUTS, to maximize treatment options and optimize patient outcomes.

The prevalence of lower urinary tract symptoms (LUTS) in the USA, the UK and Sweden: results from the Epidemiology of LUTS (EpiLUTS) study.

Abstract: OBJECTIVE To estimate and compare the prevalence and associated bother of lower urinary tract symptoms (LUTS) in the general populations of the USA, UK and Sweden using current International Continence Society (ICS) definitions, as no previous population-based studies evaluating the prevalence of LUTS in the USA, using the 2002 ICS definitions, have been conducted. SUBJECTS AND METHODS This cross-sectional, population-representative survey was conducted via the Internet in the USA, the UK and Sweden. Members of Internet-based panels were randomly selected to receive an e-mailed invitation to participate. If interested, respondents selected a link to an informed consent page, followed by the survey. Participants were asked to rate how often they experienced individual LUTS during the previous 4 weeks, on a five-point Likert scale, and, if experienced, how much the symptom bothered them. Descriptive statistics were used to summarize and present the data. RESULTS Responses rates for the USA, the UK and Sweden were 59.6%, 60.6% and 52.3%, respectively, with a final sample of 30 000 (USA 20 000; UK 7500; Sweden 2500). The mean age (range) of the participants was 56.6 (40–99) years; the mean percentages for race were 82.9% white, 6.7% black, 6.0% Hispanic and 4.4% Asian/other. The prevalence of LUTS was defined by two symptom frequency thresholds, i.e. at least ‘sometimes’ and at least ‘often’ for all LUTS except incontinence, where frequency thresholds were at least ‘a few times per month’ and at least ‘a few times per week’. The prevalence of at least one LUTS at least ‘sometimes’ was 72.3% for men and 76.3% for women, and 47.9% and 52.5% for at least ‘often’ for men and women, respectively. For most LUTS, at least half of the participants were bothered ‘somewhat’ or more using a frequency threshold of at least ‘sometimes’. For a threshold of at least ‘often’, ‘somewhat’ or more bother was reported by ≥70% of participants except for terminal dribble in men and split stream in women. CONCLUSION In this large population study of three countries, LUTS are highly prevalent among men and women aged >40 years. In general, LUTS experienced ‘often’ or more are bothersome to most people.

Effect of a standardized nurse case-management telephone intervention on resource use in patients with chronic heart failure.

Abstract: Background Case management is believed to promote continuity of care and decrease hospitalization rates, although few controlled trials have tested this approach. Objective To assess the effectiveness of a standardized telephonic case-management intervention in decreasing resource use in patients with chronic heart failure. Methods A randomized controlled clinical trial was used to assess the effect of telephonic case management on resource use. Patients were identified at hospitalization and assigned to receive 6 months of intervention (n = 130) or usual care (n = 228) based on the group to which their physician was randomized. Hospitalization rates, readmission rates, hospital days, days to first rehospitalization, multiple readmissions, emergency department visits, inpatient costs, outpatient resource use, and patient satisfaction were measured at 3 and 6 months. Results The heart failure hospitalization rate was 45.7% lower in the intervention group at 3 months ( P = .03) and 47.8% lower at 6 months ( P = .01). Heart failure hospital days ( P = .03) and multiple readmissions ( P = .03) were significantly lower in the intervention group at 6 months. Inpatient heart failure costs were 45.5% lower at 6 months ( P = .04). A cost saving was realized even after intervention costs were deducted. There was no evidence of cost shifting to the outpatient setting. Patient satisfaction with care was higher in the intervention group. Conclusions The reduction in hospitalizations, costs, and other resource use achieved using standardized telephonic case management in the early months after a heart failure admission is greater than that usually achieved with pharmaceutical therapy and comparable with other disease management approaches.

A systematic review of the literature

Abstract: OBJECTIVE — To systematically review the incidence of posttransplantation diabetes (PTD), risk factors for its development, prognostic implications, and optimal management. RESEARCH DESIGN AND METHODS — We searched databases (MEDLINE, EMBASE, the Cochrane Library, and others) from inception to September 2000, reviewed bibliographies in reports retrieved, contacted transplantation experts, and reviewed specialty journals. Two reviewers independently determined report inclusion (original studies, in all languages, of PTD in adults with no history of diabetes before transplantation), assessed study methods, and extracted data using a standardized form. Meta-regression was used to explain between-study differences in incidence. RESULTS — Nineteen studies with 3,611 patients were included. The 12-month cumulative incidence of PTD is lower (10% in most studies) than it was 3 decades ago. The type of immunosuppression explained 74% of the variability in incidence (P 0.0004). Risk factors were patient age, nonwhite ethnicity, glucocorticoid treatment for rejection, and immunosuppression with high-dose cyclosporine and tacrolimus. PTD was associated with decreased graft and patient survival in earlier studies; later studies showed improved outcomes. Randomized trials of treatment regimens have not been conducted. CONCLUSIONS — Physicians should consider modification of immunosuppressive regimens to decrease the risk of PTD in high-risk transplant recipients. Randomized trials are needed to evaluate the use of oral glucose-lowering agents in transplant recipients, paying particular attention to interactions with immunosuppressive drugs. Diabetes Care 25:583–592, 2002

2013 ACCF/AHA Guideline for the Management of Heart Failure: Executive Summary A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines

Abstract: The medical profession should play a central role in evaluating the evidence related to drugs, …

Guidelines on diabetes, pre-diabetes, and cardiovascular diseases: executive summary. The Task Force on Diabetes and Cardiovascular Diseases of the European Society of Cardiology (ESC) and of the European Association for the Study of Diabetes (EASD).

Abstract: Guidelines and Expert Consensus documents aim to present management and recommendations based on all of the relevant evidence on a particular subject in order to help physicians to select the best possible management strategies for the individual patient, suffering from a specific condition, taking into account not only the impact on outcome, but also the risk benefit ratio of a particular diagnostic or therapeutic procedure. The ESC recommendations for guidelines production can be found on the ESC website†. In brief, the ESC appoints experts in the field to carry out a comprehensive and critical evaluation of the use of diagnostic and therapeutic procedures and to assess the risk–benefit ratio of the therapies recommended for management and/or prevention of a given condition. The strength of evidence for or against particular procedures or treatments is weighed according to predefined scales for grading recommendations and levels of evidence, as outlined below. Once the document has been finalized and approved by all the experts involved in the Task Force, it is submitted to outside specialists for review. If necessary, the document is revised once more to be finally approved by the Committee for Practice Guidelines and selected members of the Board of the ESC. The ESC Committee for Practice Guidelines ( CPG ) supervises and coordinates the preparation of new Guidelines and Expert Consensus Documents produced by Task Forces, expert groups, or consensus panels. The chosen experts in these writing panels are asked to provide disclosure statements of all relationships they may have, which might be perceived as real or potential conflicts of interest. These disclosure forms are kept on file at the European Heart House, headquarters of the ESC. The Committee is also responsible for the endorsement of these Guidelines and Expert Consensus Documents or statements. | Classes of recommendations | |:-------------------------- | ------------------------------------------------------------------------------------------------------------------------ | | Class I | Evidence and/or general agreement that a given diagnostic procedure/treatment is beneficial, useful, and effective | | Class II | Conflicting evidence and/or a divergence of opinion about the usefulness/efficacy of the treatment or procedure | | Class IIa | Weight of evidence/opinion is in favour of usefulness/efficacy | | Class IIb | Usefulness/efficacy is less well established by evidence/opinion | | Class III | Evidence or general agreement that the treatment or procedure is not useful/effective and, in some cases, may be harmful | Diabetes and cardiovascular diseases (CVD) often appear …