Potentially Inappropriate Anticholinergic Medication Use in Community-Dwelling Older Adults: A National Cross-Sectional Study

Kachru, Nandita; Carnahan, Ryan M.; Johnson, Michael L.; Aparasu, Rajender R.

doi:10.1007/s40266-015-0257-x

Cited by 38 publications

(46 citation statements)

References 46 publications

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“…The prevalence of visits with any anticholinergics prescribed was stable over time, increasing minimally from 6.1% in 2006–07 to 6.8% in 2008–09 and then decreasing to 4.7% in 2014–15. These rates are slightly lower than that of a previous study using 2009–10 Medical Expenditure Panel Survey, which reported a prevalence rate of 9.6% . These marginal differences may be due to differences in data collection (e.g., individual vs visit level) or which medications were specifically included.…”

Section: Discussioncontrasting

confidence: 68%

“…On the basis of a strong recommendation grounded in systematic reviews of clinical studies, these 35 anticholinergic drugs are to be avoided regardless of indication . Previous studies investigated anticholinergic use at the national level but relied on self‐reported survey questionnaires from civilians and used old data and older versions of the Beers criteria . Furthermore, these studies were conducted cross‐sectionally such that they did not investigate secular trends of prescribing over time.…”

mentioning

confidence: 99%

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National Prescribing Trends for High‐Risk Anticholinergic Medications in Older Adults

Rhee

Choi

Ouellet

et al. 2018

J American Geriatrics Society

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OBJECTIVES:To estimate prescribing tends of and correlates independently associated with high-risk anticholinergic prescriptions in adults aged 65 and older in officebased outpatient visits. DESIGN: Repeated cross-sectional analysis. SETTING: National Ambulatory Medical Care Survey (NAMCS). PARTICIPANTS: A national sample of office-based physician visits by adults aged 65 and older from 2006 to 2015 (n596,996 unweighted). MEASUREMENTS: Prescriptions of high-risk anticholinergics, regardless of indication, were identified, and overall prescribing trends were estimated from 2006 to 2015. Stratified analyses of prescribing trends according to physician specialty and anticholinergic drug class were also performed. We used a multivariable logistic regression analysis to estimate the odds of high-risk anticholinergic prescription. RESULTS: Between 2006 and 2015, a high-risk anticholinergic prescription was listed for 5,876 (6.2%) 96,996 visits of older adults, representative of 14.6 million total visits nationally. The most common drug classes were antidepressants, antimuscarinics, and antihistamines, which accounted for more than 70% of prescribed anticholinergics. Correlates independently associated with greater odds of receiving a high-risk anticholinergic prescription were female sex, the Southern geographic region, specific physician specialties (e.g., psychiatry, urology), receipt of 6 or more concomitantly prescribed medications, and related clinical diagnoses (e.g., urinary continence) (p<.01 for all). CONCLUSION: The prevalence of high-risk anticholinergic prescriptions was stable over time but varied according to physician specialty and drug class. Quality prescribing should be promoted because safer alternatives are available.

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Section: Discussioncontrasting

confidence: 68%

mentioning

confidence: 99%

National Prescribing Trends for High‐Risk Anticholinergic Medications in Older Adults

Rhee

Choi

Ouellet

et al. 2018

J American Geriatrics Society

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Section: Introductionmentioning

confidence: 99%

“…In international studies on community‐dwelling older adults, the prevalence of PIM use ranges from 9.6%–45.8% (Bazargan et al, ; Kachru et al, ; Lu et al, ). In Brazil, investigations conducted at different locations have reported varying results regarding PIM use (Bazargan et al, ; Kachru et al, ; Lu et al, ). A study on older adults living in São Paulo (SP) identified a 28% prevalence of PIM, with associated factors being the use of five or more medications ( p = 0.001), the presence of two or more diseases ( p = 0.011) and female gender ( p = 0.007) (Cassoni et al, ).…”

Section: Introductionmentioning

confidence: 99%

Potentially inappropriate medication use and frailty phenotype among community‐dwelling older adults: A population‐based study

Bolina

Gomes

Marchiori

et al. 2019

Journal of Clinical Nursing

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Aims and objectives To investigate the association between potentially inappropriate medication use and frailty phenotype among community‐dwelling older adults and to identify factors associated with the use of these drugs according to frailty condition. Background There is insufficient evidence about the association between inappropriate medication use and the condition of frailty, particularly among community‐dwelling older adults. Therefore, data obtained from population surveys should be made available in order to support the development of clinical guidelines about the prevention of frailty. Design This was a cross‐sectional study conducted according to the STROBE Checklist. Methods This population‐based study was conducted on 1,607 older adults. Potentially inappropriate medication use was assessed according to Beers criteria and frailty syndrome was determined according to the phenotype proposed by Fried and colleagues. Data were analysed statistically using multinomial or binary logistic regression models. Results About 13.6% of the subjects were frail, and 36.8% used at least one inappropriate medication. The adjusted model indicated that, the more potentially inappropriate medication use, the higher the prevalence of frailty, prefrailty and the walking slowness component. Female gender, one or more years of schooling, five or more reported morbidities, and instrumental dependence regarding daily life activities were factors associated with potentially inappropriate medication use in the nonfrail group. Conclusion Inappropriate medication use was prevalent among community‐living older adults, and its presence was associated with the occurrence of frailty. Relevance to clinical practice Primary care nurses are the professionals with the greatest contact with the older adults in the community. Thus, the results support the inclusion of the assessment of potentially inappropriate medication use in the routine of nursing consultation. In case of a positive screening, the older person should be referred to geriatric evaluation in order to optimise drug treatment for the prevention of frailty.

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“…Anticholinergics, used by 10-27% of older adults,123 manage diverse health conditions such as overactive bladder, seasonal allergies, and depression. It is well established that these drugs can cause temporary short term impairment in cognition, including attention and reaction time 4.…”

mentioning

confidence: 99%

Anticholinergic drugs and dementia in older adults

Gray

Hanlon

2018

BMJ

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Potentially Inappropriate Anticholinergic Medication Use in Community-Dwelling Older Adults: A National Cross-Sectional Study

Cited by 38 publications

References 46 publications

National Prescribing Trends for High‐Risk Anticholinergic Medications in Older Adults

National Prescribing Trends for High‐Risk Anticholinergic Medications in Older Adults

Potentially inappropriate medication use and frailty phenotype among community‐dwelling older adults: A population‐based study

Anticholinergic drugs and dementia in older adults

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