Basic & Clinical Pharmacology & Toxicology,
Год журнала:
2021,
Номер
130(2), С. 288 - 300
Опубликована: Ноя. 27, 2021
Although
no
gold
standard
exists
to
assess
a
patient's
anticholinergic
burden,
review
identified
19
burden
scales
(ABSs).
No
study
has
yet
evaluated
whether
high
measured
with
all
ABSs
is
associated
in-hospital
mortality
and
length
of
stay
(LOS).
We
conducted
cohort
at
Swiss
tertiary
teaching
hospital
using
patients'
electronic
health
record
data
from
2015-2018.
Included
were
patients
aged
≥65
years,
hospitalised
≥48
h
without
stays
>24
in
intensive
care.
Patients'
cumulative
score
was
classified
binary
(<3:
low,
≥3:
high)
categorical
approach
(0:
no,
0.5-3:
high).
In-hospital
LOS
analysed
multivariable
logistic
linear
regression,
respectively.
included
27,092
(mean
age
78.0
±
7.5
median
6
days).
Of
them,
913
died.
Depending
on
the
ABS,
1370
17,035
exposed
anticholinergics.
Patients
by
1.32-
3.03-fold
increase
compared
those
no/low
burden.
obtained
similar
results
for
LOS.
To
conclude,
discontinuing
drugs
properties
(score
≥3)
admission
might
be
targeted
intervention
decrease
Journal of Personalized Medicine,
Год журнала:
2022,
Номер
12(2), С. 207 - 207
Опубликована: Фев. 3, 2022
The
increase
in
life
expectancy
has
also
been
accompanied
by
an
the
use
of
medication
to
treat
chronic
diseases.
Polypharmacy
is
associated
with
medication-related
problems
such
as
anticholinergic
burden.
Older
people
are
more
susceptible
effects
on
central
nervous
system
and
this,
turn,
may
be
related
cognitive
impairment.
In
this
paper,
we
develop
updated
burden
scale,
CRIDECO
Anticholinergic
Load
Scale
(CALS)
via
a
systematic
review
literature
compare
it
currently
most
used
Burden
(ACB).
Our
new
scale
includes
217
different
drugs
properties,
129
than
ACB.
Given
effect
that
medications
have
performance,
then
both
scales
investigate
relationship
between
impairment
adult
Spanish
subjects
subjective
memory
complaint.
our
population,
observed
association
when
measured
CALS,
but
not
ACB
was
applied.
comprehensive
upgraded
will
allow
better
discrimination
risk
CALS
can
help
raise
awareness
among
clinicians
medications,
or
combinations
them,
large
effect,
promote
personalized
pharmacological
approach
for
each
patient.
Medical Science Educator,
Год журнала:
2023,
Номер
33(2), С. 551 - 567
Опубликована: Фев. 23, 2023
Deprescribing
involves
reducing
or
stopping
medications
that
are
causing
more
harm
than
good
no
longer
needed.
It
is
an
important
approach
to
managing
polypharmacy,
yet
healthcare
professionals
identify
many
barriers.
We
present
a
proposed
pre-licensure
competency
framework
describes
essential
knowledge,
teaching
strategies,
and
assessment
protocols
promote
interprofessional
deprescribing
skills.
The
considers
how
involve
patients
care
partners
in
decisions.
An
action
plan
example
curriculum
mapping
exercise
included
help
educators
assess
their
curricula,
select
implement
these
concepts
strategies
within
programs
ensure
learners
graduate
with
competencies
manage
increasingly
complex
medication
regimens
as
people
age.The
online
version
contains
supplementary
material
available
at
10.1007/s40670-022-01704-9.
Research Square (Research Square),
Год журнала:
2024,
Номер
unknown
Опубликована: Янв. 5, 2024
Abstract
The
spectrum,
pathophysiology,
and
recovery
trajectory
of
persistent
post-COVID-19
cognitive
deficits
are
unknown,
limiting
our
ability
to
develop
prevention
treatment
strategies.
We
report
the
one-year
cognitive,
serum
biomarker,
neuroimaging
findings
from
a
prospective,
national
longitudinal
study
cognition
in
351
COVID-19
patients
who
had
required
hospitalisation,
compared
2,927
normative
matched
controls.
Cognitive
were
global
associated
with
elevated
brain
injury
markers
reduced
anterior
cingulate
cortex
volume
one
year
after
admission.
severity
initial
infective
insult,
post-acute
psychiatric
symptoms,
history
encephalopathy
greatest
deficits.
There
was
strong
concordance
between
subjective
objective
Treatment
corticosteroids
during
acute
phase
appeared
protective
against
Together,
these
support
hypothesis
that
moderate
severe
is
immune-mediated,
should
guide
development
therapeutic
Aging Medicine,
Год журнала:
2023,
Номер
6(2), С. 116 - 123
Опубликована: Апрель 5, 2023
Polypharmacy
is
a
growing
phenomenon
associated
with
adverse
effects
in
older
adults.
We
assessed
the
potential
confounding
of
cumulative
anticholinergic
burden
(ACB)
patients
who
were
hospitalized
falls.
Journal of the American Geriatrics Society,
Год журнала:
2023,
Номер
72(2), С. 589 - 603
Опубликована: Ноя. 25, 2023
Abstract
Background
The
Drug
Burden
Index
(DBI)
measures
an
individual's
total
exposure
to
anticholinergic
and
sedative
medications.
This
systematic
review
aimed
investigate
the
association
of
DBI
with
clinical
prescribing
outcomes
in
observational
pharmaco‐epidemiological
studies,
effect
on
functional
pre‐clinical
models.
Methods
A
search
nine
electronic
databases,
citation
indexes
gray
literature
was
performed
(April
1,
2007–December
31,
2022).
Studies
that
reported
primary
data
or
conducted
any
setting
humans
aged
≥18
years
animals
were
included.
Quality
assessment
using
Joanna
Briggs
Institute
critical
appraisal
tools
Systematic
Review
Centre
for
Laboratory
animal
Experimentation
risk
bias
tool.
Results
Of
2382
studies
screened,
70
met
inclusion
criteria
(65
humans,
five
animals).
In
included
function
(
n
=
56),
cognition
20),
falls
14),
frailty
7),
mortality
9),
quality
life
8),
hospitalization
length
stay
5),
readmission
1),
other
15)
2).
higher
significantly
associated
increased
(11/14,
71%),
poorer
(31/56,
55%),
(11/20,
55%)
related
outcomes.
Narrative
synthesis
used
due
significant
heterogeneity
study
population,
setting,
type,
definition
DBI,
outcome
measures.
could
not
be
pooled
heterogeneity.
animals,
18),
2),
1).
a
caused
frailty.
Conclusions
may
decreased
cognition.
Higher
inconsistently
mortality,
stay,
frailty,
reduced
life.
Human
findings
respect
are
supported
by
preclinical
interventional
studies.
as
tool
identify
older
adults
at
harm.
