Aging Clinical and Experimental Research, Год журнала: 2019, Номер 32(3), С. 423 - 431
Опубликована: Май 23, 2019
Язык: Английский
Advanced Drug Delivery Reviews, Год журнала: 2018, Номер 135, С. 75 - 84
Опубликована: Апрель 14, 2018
Язык: Английский
Процитировано
84
Therapeutic Advances in Drug Safety, Год журнала: 2022, Номер 13
Опубликована: Янв. 1, 2022
In the context of an ageing population, burden disease and medicine use is also expected to increase. As such, safety preventing avoidable medicine-related harm are major public health concerns, requiring further research. Potentially suboptimal regimens umbrella term that captures a range indicators may increase risk harm, including polypharmacy, underprescribing high-risk prescribing, such as prescribing potentially inappropriate medicines. This narrative review aims provide background broad overview patterns implications among older adults. Original research published between 1990 2021 was searched for in MEDLINE, using key search terms medication lists, errors, drug interactions prescriptions, along with manual checking reference lists. The summarizes prevalence, factors clinical outcomes A synthesis evidence regarding longitudinal polypharmacy provided. With existing literature, we highlight number gaps literature. Directions future include investigation into extended focusing on studies evaluate applicability tools measuring medicines study settings. Plain Language Summary Medicine age common. Older adults more than one chronic condition likely multiple manage their health. However, there times when taking be unsafe medicines, or combination used, poor outcomes. used describe all individual takes. There several ways measure regimen and, therefore, harmful. Much has been looking regimens. To bring together current research, this provides different measures It how many people experience regimens, impact it having who at greater risk. doing so, found evidence, indicating our understanding incomplete. highlights knowledge can addressed by improved able better identify those prevent minimize poorer related use.
Язык: Английский
Процитировано
32
Australian Prescriber, Год журнала: 2022, Номер 45(4), С. 118 - 120
Опубликована: Июль 29, 2022
The anticholinergic burden: from research to practice
Язык: Английский
Процитировано
29
European Journal of Ageing, Год журнала: 2024, Номер 21(1)
Опубликована: Март 29, 2024
Abstract Polypharmacy (PP) use is very common in older people and may lead to drug-drug interactions (DDIs) anticholinergic burden (ACB) that affect cognitive function. We aimed determine the occurrence of PP, potential DDIs ACB their role outcomes an population. Cross-sectional data from 636 community-dwelling adults (73.2 ± 6.0 SD, 58.6% women) participating NutBrain study (2019–2023) were analyzed. Participants asked about medication use, on extracted. The associations PP (≥ 5 drugs/day), DDIs, with mild impairment (MCI) specific domains assessed using logistic regression adjusted for confounders. Sex-stratified analysis was performed. Overall, 27.2% participants exposed 42.3% 19% cumulative ACB. Women less more than men. In multivariate analysis, odds having MCI (24%) three times higher those severe 3) (OR 3.34, 95%CI 1.35–8.25). positively associated poor executive function 4.45, 1.72–11.49) specifically Frontal Assessment Battery neuropsychological tests phonological semantic fluency. sex-stratified statistically significantly women memory anticholinergics are people. exposure MCI, particularly Clinicians encouraged be vigilant when prescribing anticholinergics. Trial registration : number NCT04461951, date July 7, 2020 (retrospectively registered, ClinicalTrials.gov).
Язык: Английский
Процитировано
6
European Journal of Clinical Pharmacology, Год журнала: 2019, Номер 76(3), С. 319 - 335
Опубликована: Дек. 12, 2019
Язык: Английский
Процитировано
47
Therapeutic Advances in Drug Safety, Год журнала: 2021, Номер 12
Опубликована: Янв. 1, 2021
Introduction: Several adverse outcomes have been associated with anticholinergic burden (ACB), and these risks increase age. approaches to measuring this are available but, date, no comparison of their prognostic abilities has conducted. This PROSPERO-registered systematic review (CRD42019115918) compared the evidence behind ACB measures in relation ability predict risk falling older people. Methods: Medline (OVID), EMBASE CINAHL (EMBSCO) PsycINFO (OVID) were searched using comprehensive search terms a validated filter for studies. Inclusion criteria included: participants aged 65 years older, use one or more measure(s) as factor, cohort case-control design, reporting falls an outcome. Risk bias was assessed Quality Prognosis Studies (QUIPS) tool. Results: Eight studies temporal associations between included. All rated high ⩾1 QUIPS tool categories, five ⩾3 categories. (274,647 participants) showed some degree association score increased falls. Findings most significant moderate levels ACB. Most (6/8) utilised cognitive scale. No directly two there variation how measured analysis. Conclusion: The supports people, but conclusion can be made regarding which scale offers best value Plain language summary A published explore is at predicting people One third will experience fall. Falls many consequences including fractures, loss independence being unable enjoy life. Many things chances having includes medications. type medication, known may These medications used treat common health issues depression bladder problems. Anticholinergic term describe total effects from taking Some than would burden. It possible that reducing could reduce We need carry out see if possible. To do this, we able measure There several scales available, not know best. wanted answer: ‘Which people?’. reviewed answer this. did way capture all restricted ways. only included relevant our question. found eight learned who users (often medications) had higher falling. less clear lower low number prevented us determining better another. findings suggest should improve well-being
Язык: Английский
Процитировано
29
British Journal of Clinical Pharmacology, Год журнала: 2022, Номер 89(2), С. 687 - 698
Опубликована: Авг. 30, 2022
The drug burden index (DBI) measures a person's total exposure to anticholinergic and sedative medications, which are commonly associated with harm. Through incorporating the DBI in electronic medical records (eMR) implementing stewardship program, we aimed determine (i) uptake of steward's recommendations deprescribe and/or drugs by team (ii) whether accepted were actioned hospital or recommended for follow-up General Practitioner post-discharge.
Язык: Английский
Процитировано
20
Expert Opinion on Pharmacotherapy, Год журнала: 2025, Номер unknown, С. 1 - 10
Опубликована: Фев. 1, 2025
Overactive bladder (OAB) is a prevalent disorder with significant impact on quality of life. The pathophysiology OAB multifactorial and the majority patients will require treatment multiple therapies across course their disease. First line treatments include retraining, fluid advice pelvic floor muscle training. Following this, may be offered anticholinergic β3 agonist medications. Anticholinergics are known to have high rates discontinuation due side effects there concerns regarding load its cognitive function in older adults. This paper aims discuss current emerging options available for who suffer from OAB. management clinical setting remains challenging. goal newer pharmacotherapies would that provides long term symptomatic relief minimal an improved future research promising should consider implications gut-bladder axis, regenerative medicine, biomarkers role digital health.
Язык: Английский
Процитировано
0
The journal of nutrition health & aging, Год журнала: 2025, Номер 29(5), С. 100507 - 100507
Опубликована: Фев. 13, 2025
Язык: Английский
Процитировано
0
BMJ Medicine, Год журнала: 2025, Номер 4(1), С. e001125 - e001125
Опубликована: Фев. 1, 2025
To assess the association between cumulative use of anticholinergic bladder drugs and risk all cause dementia compared with non-use β3 agonist drug, mirabegron. Danish nationwide active comparator study. National registries, 1 January 2000 to 31 December 2022. 29 254 individuals were matched by age sex 646 270 controls without dementia, identified from a cohort 2.26 million aged 60-75 years 2022 no previous dementia. Two separate nested case-control populations studied: general population an 58 242 new users (2198 developed 10 990 controls). Information on medication was based filled prescriptions defined daily doses. Conditional logistic regression provided incidence rate ratios for associations mirabegron adjusted educational level, cardiovascular disease, diabetes, hypertension, dyslipidaemia, Charlson Comorbidity Index. Compared non-use, ever associated increased ratio 1.44 (95% confidence interval (CI) 1.40 1.48). The increasing drug use, 1.31 CI 1.27 1.36) 1-90 doses 1.68 (1.59 1.76) >365 types dementia: tolterodine 1.43 1.38 1.49), solifenacin 1.37 (1.29 1.46), trospium 1.52 (1.37 1.67), fesoterodine 1.48 (1.26 1.74). not seen when directly (incidence 0.82, 95% 0.74 0.92), irrespective type drug. In this study, but applying These findings highlight relevance using comparator. Future research should evaluate cognitive impairment both drugs.
Язык: Английский
Процитировано
0