Introduction: Reducing healthcare disparities includes advancing equity for our patients. Significant disparities exist in the diagnosis & treatment of overactive bladder (OAB). Our objective was thus to analyze if race influences receipt of advance therapies for urgency urinary incontinence (UUI) or OAB. Methods: The TriNetX Diamond network was queried to identify adult females with a diagnosis of UUI (N39.41) or OAB (N32.81), excluding those with stress incontinence (N39.3) or mixed incontinence (N39.46). Propensity-score matching was conducted for age at diagnosis, current age, outpatient (1013626), inpatient (1013659), & emergency department (1013711) service utilizations. Treatments were categorized according to AUA guidelines: 1st line therapies included biofeedback training (90911, 90912, 90913, 1035670) or physical therapy (97161, 97162, 97163, Z51.89, 1029677); 2nd line included oxybutynin (32675), darifenacin (136198), solifenacin (322167), tolterodine (119565), fesoterodine (797195), trospium chloride (236778), or mirabegron (1300786); 3rd line included percutaneous tibial nerve stimulation (64581), sacral neuromodulation (64561, 64566), or OnabotulinumtoxinA injection (52287, J0585) in 1, 3, or 5 years from diagnosis. Results: We identified 1,534,042 adult females with OAB or UUI; 437,401 identified as white & 57,458 identified as black. The number of individuals receiving treatment & advancement in treatment over the years are listed in Table 1. 57,413 black females were compared to an equivalent number of propensity-score matched white females. No significant difference was observed in initial access to 1st line treatment. Significant difference was observed in advanced treatment prescriptions between race (Table 2). Conclusions: Though initial 1st line treatment prescription is similar by race; our results demonstrate a significantly lower rate of prescription of 2nd or 3rd line therapies for black individuals. These results highlight the need for further research to understand these differences. SOURCE OF Funding: NA
