Potentially inappropriate prescriptions of anticholinergic drugs in patients with benign prostatic hyperplasia

Valladales‐Restrepo, Luis Fernando; Machado‐Alba, Jorge Enrique

doi:10.1080/13685538.2019.1595572

Cited by 5 publications

(3 citation statements)

References 37 publications

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“…The differences found among cities in the prescription of drugs with anticholinergic properties in patients with Alzheimer's disease might be due to the different prescription habits of physicians and their academic training. These differences have already been found in other pharmacoepidemiological studies …”

Section: Discussionsupporting

confidence: 65%

Potentially inappropriate prescriptions of anticholinergics drugs in Alzheimer's disease patients

Valladales‐Restrepo

Duran-Lengua

Machado‐Alba

2019

Geriatrics Gerontology Int

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Aim: Alzheimer's disease is a common cause of dementia, and is usually treated with medications that elevate acetylcholine levels. The objective of the present study was to identify drugs with anticholinergic properties prescribed to patients diagnosed with Alzheimer's disease in Colombia. Methods:A cross-sectional study was carried out in outpatients diagnosed with Alzheimer's disease who were identified from a population database from Colombia, and had been treated with cholinesterase inhibitors and glutamate N-methyl-D-aspartate receptor antagonists. The anticholinergic burden was evaluated using the Anticholinergic Cognitive Burden scale, and patients were classified on a scale of 0-3 points according to anticholinergic potential, and were grouped into those with mild-to-moderate (1-2 points) or high (≥3 points) anticholinergic load.Results: The study included 4134 Alzheimer's disease patients. The mean age was 81.50 AE 8.16 years, and 67.8% were women. At least 22.9% of patients took anticholinergic drugs. Of these, the most frequently prescribed medication was quetiapine (8.6%). Age >85 years was associated with a high risk of having an anticholinergic burden ≥3 points (OR 2.19,. Potential interactions between cholinesterase inhibitors and anticholinergic drugs were identified in 7.8% of patients. Conclusions:The majority of patients who were prescribed anticholinergic drugs were older women, had a significant total anticholinergic burden and had frequent pharmacological interactions with cholinesterase inhibitors. The use of anticholinergics reduces the clinical effectiveness of antidementia drugs and increases the risk of adverse reactions. Geriatr Gerontol Int 2019; 19: 913-917.

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Section: Discussionsupporting

confidence: 65%

Potentially inappropriate prescriptions of anticholinergics drugs in Alzheimer's disease patients

Valladales‐Restrepo

Duran-Lengua

Machado‐Alba

2019

Geriatrics Gerontology Int

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“…In addition to the above findings, one-fifth of the patients who were prescribed antimuscarinics presented with concomitant glaucoma, constipation, sicca syndrome, dementia or prostatic hyperplasia. This is in line with other pharmacoepidemiological studies that documented that the use of antimuscarinic drugs in patients with these pathologies ranged between 22.9% and 41.0% 30 , 31 , 34 – 36 and for which drug–disease interactions could be associated with an increased risk of adverse drug reactions. 8 , 12 , 33 Therefore, the anticholinergic burden at the time of comprehensive treatment of these patients should be taken into account, 3 , 8 , 12 , 32 prolonged-release pharmaceutical forms should be preferentially used, 3 and most importantly, other therapeutic options, such as mirabegron, vaginal estrogens, or nonpharmacological interventions, should be considered.…”

Section: Discussionsupporting

confidence: 90%

Patterns of use of medications used to treat urinary incontinence and potentially inappropriate prescriptions

Valladales‐Restrepo

Bedoya-Arias

Aristizábal-Carmona

et al. 2023

Therapeutic Advances in Urology

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Background: The pharmacological treatment of urinary incontinence (UI) may involve bladder antimuscarinics, which can generate risks in the elderly. Objective: The aim was to determine the treatment patterns of a group of patients with UI and possible potentially inappropriate prescriptions. Design and methods: This was a cross-sectional study that identified prescription patterns of medications for outpatient use in patients with UI between December 2020 and November 2021 based on a population database of members of the Colombian Health System. Patients were identified based on the codes of the international classification of diseases, version-10. Sociodemographic and pharmacological variables were considered. Results: A total of 9855 patients with UI were identified, with a median age of 72 years, and 74.6% were women. Unspecified UI was the most frequent form (83.2%), followed by specified UI (7.9%), stress UI (6.7%), and UI associated with an overactive bladder (2.2%). A total of 37.2% received pharmacological treatment, mainly with bladder antimuscarinics (22.6%), mirabegron (15.6%), and topical estrogens (7.9%). Pharmacological management predominated in UI associated with overactive bladder, in women and in patients between 50 and 79 years of age. Of the patients who received bladder antimuscarinics, 54.5% were 65 years old or older, and 21.5% also had benign prostatic hyperplasia, sicca syndrome, glaucoma, constipation, or dementia. A total of 2.0% of women had been prescribed systemic estrogens and 1.7% had been prescribed peripheral α-adrenergic antagonists. Conclusion: Differences in the prescriptions were found according to the type of UI, sex, and age group. Potentially inappropriate or risky prescriptions were common.

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“…This anticholinergic burden may decrease bladder contractility and increase postvoid residual. Medications with anticholinergic effects are prescribed more commonly in patients with BPH [34]. Hence, stopping medications with strong anticholinergic effect prior to TWOC may enhance the chances of spontaneous voiding recovery.…”

Section: Associated Measures To Improve Voiding Recoverymentioning

confidence: 99%

Best nonsurgical managements of acute urinary retention: what's new?

Baboudjian

Benoit

Boissier

et al. 2021

Current Opinion in Urology

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Purpose of reviewTo provide a comprehensive review of the nonsurgical management of acute urinary retention (AUR). Recent findingsA recent meta-analysis confirmed that a-blockers are associated with higher rates of successful trial without catheter (TWOC) compared with placebo, while combination therapies do not significantly reduce the rate of recatheterization. Compared with standard TWOC, bladder perfusion with physiological serum prior to catheter removal is a simple and cost-effective method to increase TWOC success rates (odds ratio 2.41, 95% confidence interval 1.53-3.8), and to reduce time-to-discharge (À89.68 min, 95% confidence interval À160.55, À18.88). Clean intermittent catheterization (CIC) is increasingly used for urinary retention in patients with benign prostatic hyperplasia as existing data suggest that it may decrease the risk of urinary tract infections, accelerate spontaneous voiding recovery and might be more cost-effective compared with indwelling urethral catheterization. Ongoing trials are examining whether office-placed prostate stent may be a promising solution in patients with AUR.

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Potentially inappropriate prescriptions of anticholinergic drugs in patients with benign prostatic hyperplasia

Cited by 5 publications

References 37 publications

Potentially inappropriate prescriptions of anticholinergics drugs in Alzheimer's disease patients

Potentially inappropriate prescriptions of anticholinergics drugs in Alzheimer's disease patients

Patterns of use of medications used to treat urinary incontinence and potentially inappropriate prescriptions

Best nonsurgical managements of acute urinary retention: what's new?

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