Stakeholders' perspective on modalities to reduce anticholinergic burden

2022 ◽  
Vol 33 (2) ◽  
pp. 2-3
Author(s):  
Y. W. Francis Lam
Keyword(s):  
Anticholinergic Burden

Anticholinergic Burden Can Add Up Fast

2008 ◽  
Vol 41 (8) ◽  
pp. 18
Author(s):  
SHERRY BOSCHERT
Keyword(s):  
Anticholinergic Burden

Anticholinergic Burden among Hospitalised Older Adults with Psychiatric Illnesses- A retrospective study

2020 ◽  
Vol 15 ◽  
Author(s):  
Shiva Shanker Reddy Mukku ◽  
Preeti Sinha ◽  
Palanimuthu Thangaraju Sivakumar ◽  
Mathew Varghese
Keyword(s):  
Older Adults ◽  
Retrospective Study ◽  
Psychiatric Disorders ◽  
Psychotropic Drugs ◽  
Inpatient Care ◽  
Medical Illness ◽  
Anticholinergic Effects ◽  
Psychiatric Illnesses ◽  
Anticholinergic Burden ◽  
Number Of Males

Background: Drugs with anticholinergic properties are known to be associated with deleterious effects on cognition in older adults. There is a paucity of literature in this aspect in older adults with psychiatric disorders. Objective: To examine the anticholinergic cognitive burden and its predictors in hospitalised older adults having psychiatric disorders. Methods: Case records of older adults who sought inpatient care under the Geriatric Psychiatry Unit from January, 2019 to June, 2019 were reviewed. The anticholinergic burden was assessed with Anticholinergic Cognitive Burden (ACB) scale updated version, 2012. Results: Sample included 129 older adults with an almost equal number of males (53.48%) and females (46.52%) having a mean age of 67.84 (SD = 6.96) years. The diagnostic spectrum included depression (34.89%), dementia (31.01%), mania (10.85%), psychosis (13.95%), delirium (6.20%) and others (3.1%). 60.47% of the patients had more than one medical illness. 48.84% of the older adults had clinically relevant anticholinergic cognitive burden ( ACB score ≥ 3). Use of 3 or more psychotropic drugs (OR = 4.88), diagnosis of psychosis/ mania (OR = 7.62) and dementia/ delirium (neurocognitive disorders group) (OR = 5.17) increased the risk of ACB score ≥ 3. Conclusion: Nearly half of the older adults in psychiatry in-patient setting had clinically relevant anticholinergic burden, which was associated with higher use of psychotropics. Our study highlights the importance of monitoring for anticholinergic effects of psychotropics in older adults.

Development of an Emergency Revisit Score for Patients With Drug-Related Problems

2021 ◽  
pp. 875512252110117
Author(s):  
Jesus Ruiz Ramos ◽  
Laura Gras-Martin ◽  
Ana María Juanes Borrego ◽  
Marta Blazquez-Andion ◽  
Mireia Puig Campmany ◽  
...  
Keyword(s):  
Risk Factors ◽  
High Risk ◽  
Receiver Operating Curve ◽  
Drug Related Problems ◽  
Derivation Cohort ◽  
Factors Associated ◽  
Final Score ◽  
Anticholinergic Burden ◽  
Risk Categories ◽  
Frequent Reason

Background: Drug-related problems (DRPs) are a frequent reason for emergency departments (EDs) visits. However, data about the risk factors associated with EDs revisits are limited. Objective: To develop and validate a predictive model indicating the risk factors associated with EDs revisit within 30 days of the first visit. Methods: A retrospective cohort study was conducted involving patients who attended an ED for DRPs related to cardiovascular drugs. A 30-day prediction model was created in a derivation cohort by logistic regression. An integer score proportional to the regression coefficient was assigned to the variables with P < .100 in the multivariate analysis. Results: 581 patients (mean age: 80.0 [12.6] years) were included, 133 (22.9%) revisited the ED within 30 days from discharge. Six factors (chronic kidney disease, chronic heart failure, visit to an ED in the preceding 3 months, high anticholinergic burden, DRPs associated with heparin, and safety-related DRPs) were identified as risk factors and combined into a final score, termed the DREAMER score. The model reached an area under the receiver operating curve values of 0.72 (95% confidence interval [CI] = 0.67-0.77) in the referral cohort and 0.71 (95% CI = 0.65-0.74) in the validation cohort ( P = .273). Three risk categories were generated, with the following scores and estimated risks: low risk (0-8 points): 11.6%; intermediate risk (9-14 points): 21.3%; and high risk (>14 points): 41.2%. Conclusion and Relevance: The DREAMER score identifies patients at high risk for ED revisit within 30 days from the first visit for a DRPs, being a useful tool to prioritize interventions on discharge.

scholarly journals 5PSQ-209 Anticholinergic burden and risk of adverse events in patients from a Spanish nursing home

2021 ◽  
Author(s):  
H Rodríguez Ramallo ◽  
E Prado Mel ◽  
R Ramos Romero ◽  
MI Galván-Borras ◽  
JC Huarte Mendicoa ◽  
...  
Keyword(s):  
Nursing Home ◽  
Adverse Events ◽  
Anticholinergic Burden

scholarly journals Prescribing Trends of Anticholinergic Drugs Between 1989 and 2017: A UK Biobank Study

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 209-209
Author(s):  
Jure Mur ◽  
Simon Cox ◽  
Riccardo Marioni ◽  
Tom Russ ◽  
Graciela Muniz Terrera
Keyword(s):  
Prescription Drugs ◽  
Anticholinergic Drug ◽  
Later Life ◽  
Anticholinergic Drugs ◽  
Uk Biobank ◽  
Linear Estimate ◽  
Cross Sectional ◽  
Increased Risk ◽  
Prescribing Trends ◽  
Anticholinergic Burden

Abstract Prescription drugs with anticholinergic properties are commonly prescribed and negatively impact physical performance, cognitive function, and increase the risk of falls and dementia. The prevalence of anticholinergic drugs is high in later life, when there is an increased risk of adverse drug effects. Recent, in-depth longitudinal analyses of specifically anticholinergic prescribing in Europe is lacking. Prescriptions for the UK-Biobank participants (n=222,122) were ascertained from primary care electronic patient records. We assigned anticholinergic activity to each drug by using a composite score. We used linear regression to study the association between current anticholinergic burden and time period, explore secular trends in anticholinergic use, and various demographic factors. We further explored the results in the context of different classes of prescriptions drugs. 74 distinct drugs in the sample (1.1%) had anticholinergic effects. An individual’s overall anticholinergic burden increased nonlinearly (linear estimate=0.474, quadratic estimate = 0.094, both p&lt;2.2x10-16) between 1989 (mean=0.09, σ=0.009) and 2000 (mean=0.22, σ=0.006) and increased nonlinearly (linear estimate=0.282, quadratic estimate=0.074, both p&lt;2.2x10-16) from 2000 to 2016 (mean=0.27, σ=0.009). The proportion of patients prescribed at least one anticholinergic drug per month increased from 6.1% to 16.7% from 1989 to 2000 and increased to 18.6% by 2016. When adjusted for sex and polypharmacy, age was negatively associated with recent cross-sectional anticholinergic burden (estimate=-0.042, p&lt;2.2x10-16). Our results demonstrate an increase in prescribing of anticholinergic drugs over the past 30 years and indicate contemporary deprescribing of anticholinergic drugs in the later decades of life.

scholarly journals Anticholinergic Burden and Dry Mouth in Middle-Aged People

2019 ◽  
Vol 5 (1) ◽  
pp. 62-70
Author(s):  
A. Tiisanoja ◽  
A.-M.H. Syrjälä ◽  
A. Kullaa ◽  
P. Ylöstalo
Keyword(s):  
Regression Models ◽  
Antihypertensive Drugs ◽  
Salivary Flow ◽  
Dry Mouth ◽  
Subjective Feeling ◽  
Oral Diseases ◽  
Middle Aged ◽  
Aged People ◽  
Prophylactic Measures ◽  
Anticholinergic Burden

Introduction:Anticholinergic burden refers to the cumulative effect of taking 1 or more drugs with anticholinergic properties. At the moment, little is known about the association between the anticholinergic burden and dry mouth.Objectives:The objective of this article was to study, whether an anticholinergic burden is associated with dry mouth among middle-aged people.Methods:The study population included 1,345 people aged 46 y from the Northern Finland Birth Cohort 1966 (NFBC1966) study, who took part in a clinical medical and dental examination during 2012–2013. Medication data comprised both self-reported drug use and information obtained from the national register. Anticholinergic burden was measured using 10 different anticholinergic scales. Dry mouth was defined on the basis of having either a subjective feeling of dry mouth (xerostomia) or objectively measured low unstimulated or stimulated whole salivary flow rates (hyposalivation). Poisson regression models with robust error variance were used to estimate relative risk (RR). Regression models were adjusted for sex, smoking, diabetes, rheumatoid diseases, depressive symptoms, anxiety, total number of drugs, and antihypertensive drugs.Results:Approximately 14% of the participants reported having xerostomia and about 2% had hyposalivation. The RRs of different anticholinergic scales for xerostomia varied from 1.05 to 1.68. The scales’ RRs were between 0.89 and 2.03 for low unstimulated whole salivary flow (<0.1 mL/min) and between 0.59 and 1.80 for low stimulated whole salivary flow (<0.7 mL/min). Seven of 10 studied anticholinergic scales associated statistically significantly with dry mouth, either with xerostomia or hyposalivation.Conclusion:Most of the anticholinergic scales were associated with dry mouth, either with xerostomia or hyposalivation. There was considerable variation in the strength of the associations between anticholinergic scales and dry mouth.Knowledge Transfer Statement:The findings of this study suggest that dentists should take notice of the use of drugs with anticholinergic properties and their harmful effects among middle-aged people. Dentists should provide these patients with necessary guidance on how to cope with dry mouth and give them prophylactic measures against oral diseases associated with dry mouth.

scholarly journals 119 * TOTAL ANTICHOLINERGIC BURDEN (ACB) AND IN-PATIENT HOSPITAL MORTALITY AND LENGTH OF STAY IN PATIENTS AGED>= 90 YEARS ADMITTED WITH AN ACUTE ILLNESS

2014 ◽  
Vol 43 (suppl 1) ◽  
pp. i33-i33
Author(s):  
A. C. Kidd ◽  
P. Musonda ◽  
R. L. Soiza ◽  
C. Butchart ◽  
C. J. Lunt ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Hospital Mortality ◽  
Acute Illness ◽  
Anticholinergic Burden

Confusion Regarding Anticholinergic Burden Measurement

2015 ◽  
Vol 63 (5) ◽  
pp. 1054-1054 ◽  
Author(s):  
Unax Lertxundi ◽  
Saioa Domingo-Echaburu ◽  
Rafael Hernández ◽  
Javier Peral-Aguirregoitia ◽  
Juan Medrano
Keyword(s):  
Anticholinergic Burden

A comparison of anticholinergic burden in older patients with and without cancer

2021 ◽  
Author(s):  
Ayse Irem Yasin ◽  
Atakan Topcu ◽  
Meysere Nur Akuc ◽  
Hacı Mehmet Türk ◽  
Pinar Soysal
Keyword(s):  
Older Patients ◽  
Nutritional Assessment ◽  
Geriatric Depression Scale ◽  
Depression Scale ◽  
Mini Nutritional Assessment ◽  
Patients With Cancer ◽  
Cancer Management ◽  
Rational Drug ◽  
Geriatric Clinic ◽  
Anticholinergic Burden

Aim: To compare anticholinergic burden (ACB) in older patients with and without cancer and evaluate the effects of ACB on geriatric syndromes. Methods: A total of 291 patients from the geriatric clinic and 301 patients from the oncology clinic were evaluated. ACB <2 was categorized as low ACB and ACB ≥2 was categorized as high ACB. A comprehensive geriatric assessment was performed on patients from the geriatric clinic. Results: ACB scores were significantly higher in patients without cancer compared with those with cancer (p < 0.005). Number of falls and Geriatric Depression Scale 15 scores were higher and Mini-Nutritional Assessment and Barthel/Lawton activities of daily living scores were lower in geriatric patients with high ACB scores compared with those with low ACB scores (p < 0.005). Conclusion: It is crucial to understand the potential effects of ACB for rational drug use and optimum cancer management in older patients with cancer.

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