Geriatrics Gerontology and Aging,
Год журнала:
2023,
Номер
17
Опубликована: Янв. 1, 2023
Objectives:
To
estimate
the
anticholinergic
burden
in
geriatric
patients
using
two
scales
and
to
assess
degree
of
agreement
between
them.
Methods:
Data
from
an
observational
study
conducted
a
primary
health
care
service
were
used.
Anticholinergic
was
assessed
Belgian
Scale
Muscarinic
Acetylcholinergic
Receptor
ANTagonist
Exposure
Brazilian
Medicines
with
Activity.
The
cumulative
score
classified
categorical
approach:
scale
(0:
none;
1
–
2:
low;
≥
3:
high)
0.5
1.5:
high).
instruments
obtained
through
Cohen’s
kappa
coefficient.
Results:
A
total
374
older
people
included,
most
them
female
aged
60
69
years.
At
least
one
potentially
inappropriate
drug
activity
used
by
60.70%
according
32.89%
scale.
On
average,
20.85%
under
high
exposure.
Overall,
on
both
scales,
commonly
recurrent
medications
those
indicated
for
treatment
psychiatric
disorders.
Agreement
moderate
(Kappa
=
0.43).
Conclusions:
percentage
adults
exposed
drugs
burden,
posing
risks
quality
life.
Consensus
is
needed
how
calculated
these
scores,
as
well
standardization
list
included
drugs.
British Journal of Clinical Pharmacology,
Год журнала:
2022,
Номер
88(11), С. 4915 - 4927
Опубликована: Июнь 8, 2022
A
recent
review
identified
19
anticholinergic
burden
scales
(ABSs)
but
no
study
has
yet
compared
the
impact
of
all
ABSs
on
delirium.
We
evaluated
whether
a
high
as
classified
by
each
ABS
is
associated
with
incident
delirium.We
performed
retrospective
cohort
in
Swiss
tertiary
teaching
hospital
using
data
from
2015-2018.
Included
were
patients
aged
≥65,
hospitalised
≥48
hours
stay
>24
intensive
care.
Delirium
was
defined
twofold:
(i)
ICD-10
or
CAM
and
(ii)
DOSS.
Patients'
cumulative
score,
calculated
within
24
after
admission,
binary
(<3:
low,
≥3:
burden)
categorical
approach
(0:
no,
0.5-3:
burden).
Association
analysed
multivariable
logistic
regression.Over
25
000
(mean
age
77.9
±
7.6
years)
included.
Of
these,
864
(3.3%)
2770
(11.0%)
developed
Depending
ABS,
4-63%
exposed
to
at
least
one
drug.
Out
ABSs,
14
16
showed
significant
association
outcomes.
patient
score
had
odds
ratios
(ORs)
1.21
(95%
confidence
interval
[CI]:
1.03-1.42)
2.63
CI:
2.28-3.03)
for
delirium
those
low
burden.A
admission
significantly
Although
prospective
studies
need
confirm
these
results,
discontinuing
substituting
drugs
≥3
might
be
targeted
intervention
reduce
Health Science Reports,
Год журнала:
2023,
Номер
6(5)
Опубликована: Май 1, 2023
Abstract
Background
and
Aims
Potentially
inappropriate
medications
(PIMs)
carry
risks
that
outweigh
any
potential
benefits
when
compared
to
safer
or
more
effective
alternative
treatments.
Adverse
drug
events
are
likely
occur
in
older
adults
with
psychiatric
diseases
due
multimorbidity,
polypharmacy,
age‐related
changes
pharmacokinetics
pharmacodynamics.
The
aim
of
this
study
was
assess
the
prevalence
risk
factors
PIM
use
an
aged
care
hospital's
psychogeriatric
division,
using
American
Geriatrics
Society
Beers
criteria
2019.
Methods
This
cross‐sectional
conducted
on
all
current
inpatients,
having
a
mental
disorder
≥65
years,
one
elderly
hospital
Beirut,
from
March
May
2022.
Medications,
sociodemographic
clinical
characteristics
were
collected
patients'
medical
records.
PIMs
evaluated
based
Independent
variables
described
descriptive
statistics.
Factors
associated
identified
by
bivariate
analysis
followed
binary
logistic
regression.
A
two‐sided
p
value
<0.05
considered
statistically
significant.
Results
included
147
patients,
mean
age
76.3
46.9%
them
schizophrenia,
68.7%
5
drugs
90.5%
taking
at
least
1
PIM.
most
prescribed
antipsychotics
(40.2%),
anticholinergics
(16%),
antidepressants
(7.8%).
significantly
polypharmacy
(AOR
=
20.88,
95%
CI:
1.22−357.87,
0.04)
anticholinergic
cognitive
burden
(ACB)
score
7.25,
1.13−46.52,
0.04).
Conclusion
highly
prevalent
among
hospitalized
Lebanese
elderly.
Polypharmacy
ACB
determinants
use.
multidisciplinary
medication
review
led
pharmacist
could
reduce
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
The Senior Care Pharmacist,
Год журнала:
2024,
Номер
39(7), С. 249 - 258
Опубликована: Июнь 28, 2024
In
older
inpatients,
anticholinergic
medications
can
increase
the
risk
of
complications
that
may
length
stay
(LOS).
Cyclobenzaprine
is
an
medication
associated
with
mental
status
changes,
falls,
and
injuries
in
patients.
Frontiers in Pharmacology,
Год журнала:
2024,
Номер
15
Опубликована: Июнь 12, 2024
Aim
The
anticholinergic
properties
of
medications
are
associated
with
poorer
cognitive
performance
in
schizophrenia.
Numerous
scales
have
been
developed
to
assess
burden
and
yet,
there
is
no
consensus
indicating
which
scale
more
relevant
for
patients
We
aimed
identify
valid
estimating
the
risk
iatrogenic
impairment
Methods
identified
27
a
literature
review.
responses
neuropsychological
tests
839
individuals
schizophrenia
or
schizoaffective
disorder
FACE-SZ
database
were
collected
between
2010
2021.
estimated
association
objective
global
scales,
number
psychotropic
drugs,
chlorpromazine
lorazepam
equivalents
bivariable
regressions
cross-sectional
design.
then
adjusted
models
covariates:
predictors
significantly
multiple
linear
considered
good
concurrent
validity
performance.
Results
Eight
drug
impairment.
most
convenient
predictor
compute,
was
worse
executive
function
(Standardized
β
=
−0.12,
p
.004)
reasoning
−0.08,
.037).
Conclusion
Anticholinergic
burden,
weakly
cognition,
thus
suggesting
that
explained
by
factors
other
than
medication.
drugs
parsimonious
method
Therapeutic Advances in Drug Safety,
Год журнала:
2024,
Номер
15
Опубликована: Янв. 1, 2024
Numerous
studies
report
that
anticholinergic
burden
(ACB)
has
been
linked
with
several
health
consequences,
including
increased
hospital
admissions,
prolonged
hospitalization,
and
physical
cognitive
impairment.
However,
low-
middle-income
settings,
as
well
younger
individuals,
are
underrepresented.
Abstract
Background
Exposure
to
high
anticholinergic
burden
is
associated
with
adverse
outcomes
in
older
adults.
Older
adults
frailty
have
greater
vulnerability
effects.
There
limited
data
on
hospitalised
particularly,
New
Zealand.
This
study
aimed
(i)
examine
exposure
medicines
inpatients
using
multiple
scales,
and
(ii)
describe
the
association
of
patient
factors
such
as
exposure.
Methods
We
reviewed
admission
discharge
222
patients
(≥
65
years)
a
Zealand
hospital.
Sociodemographic,
diagnostic
medication
were
collected
from
electronic
health
records.
Anticholinergic
was
quantified
Burden
Classification
(ABC),
Cognitive
Scale
(ACB),
Risk
(ARS),
Drug
Index
(DBI).
Frailty
assessed
index
(FI)
Hospital
score
(HFRS);
higher
scores
indicate
frailty.
Multivariable
logistic
regression
analysis
used
determine
burden.
Results
Depending
scale
used,
mean
ranged
0.65
1.83
0.59
1.40
at
discharge,
32–74%
25–65%
prescribed
least
one
medicine.
About
1
3
had
discharge.
On
admission,
being
frail
(adjusted
odds
ratio
[AOR]
5.16,
95%
confidence
interval
[95%
CI]
1.57,
16.97),
having
history
readmission
(AOR
4.96,
CI
1.58,
15.59),
number
[AOR
range
1.18
1.10,
1.26
(ARS
scale)
1.25
1.15,
1.36
(DBI
scale)]
At
pre-frail
scale:
AOR
=
6.58,
1.71–25.32)
(ACB
5.73,
1.66,
19.70)
those
1.09,
1.29
1.33
1.20,
1.49
Conclusion
A
reduction
observed
population
yet,
one-third
cohort
discharged
medicines.
Enhancing
hospital
prescribers’
pharmacists’
awareness
about
targeted
interventions
in-hospital
deprescribing
are
needed
reduce
acute
setting.
