Prevalence, risk factors and adverse outcomes of anticholinergic burden in patients with advanced chronic conditions at hospital admission

Sevilla-Sánchez, Daniel; Molist-Brunet, Núria; González-Bueno, J; Solà-Bonada, Núria; Espaulella-Panicot, Joan; Codina-Jané, Carles

doi:10.1111/ggi.13330

Cited by 18 publications

(27 citation statements)

References 28 publications

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“…Patients with anticholinergic drugs had more comorbidity (CRG ≥ 6/05) [39]. The presence of moderate and excessive polypharmacy (≥5 and ≥10 drugs) has been found to be a risk factor for the presence of anticholinergic medication; data in concordance with those observed by Sevilla et al [30]. Only the ARS scale showed significant relationship between anticholinergic burden and AEs, also in the rate of AEs per patient.…”

Section: Discussionsupporting

confidence: 86%

“…Pharmacologic variables included: Number of concomitant medication at starting DAAs (patients were classified as "oligopharmacy" if <5 drugs, "moderate polypharmacy" if 5-9 drugs and "excessive polypharmacy" if ≥10 drugs) [30]. Qualitative classification of drugs under the Anatomical Therapeutic Chemical (ATC) classification System.…”

Section: Exposure To Polypharmacy and Anticholinergic Medicationmentioning

confidence: 99%

“…Multiple scales exist for the measurement of the anticholinergic burden but they show differences in terms of the medications they include and the anticholinergic potency score for each medication [10,12,29]. Among the most used are the Anticholinergic Cognitive Burden (ACB) scale, the Anticholinergic Risk Scale (ARS) and the Anticholinergic Drug Scale (ADS) [12,[30][31][32][33][34].…”

Section: Introductionmentioning

confidence: 99%

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Anticholinergic Burden and Safety Outcomes in Older Patients with Chronic Hepatitis C: A Retrospective Cohort Study

Amoros-Reboredo

Soy

Hernández

et al. 2020

IJERPH

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Aim: Older patients with chronic hepatitis C infection starting direct-acting antivirals (DAAs) are frequently prescribed multiple medications that may be categorized as inappropriate. Anticholinergic burden has been shown to be a predictor of adverse health and functional outcomes. Different scales are available to calculate anticholinergic burden. The aim of this study was to determine the prevalence of anticholinergic medication among older patients treated with DAAs and the risk factors associated using the Anticholinergic Cognitive Burden (ACB) scale, the Anticholinergic Risk Scale (ARS) and the Anticholinergic Drug Scale (ADS) and analyze the resulting safety consequences. Methods: Observational, retrospective cohort study of consecutive patients ≥65 years old receiving DAAs and taking concomitant medication. This study was conducted in accordance with the Strengthening the Reporting of observational studies in Epidemiology Statement. Results: 236 patients were included. The average age was 71.7 years, 73.3% cirrhotic, and 47% patients took ≥5 medicines. According to the ACB, ARS and ADS scales, 35.2% (n = 83), 10.6% (n = 25) and 34.3% (n = 81) of the patients were treated with anticholinergic medication. Two hundred-and-six (86%) patients presented any adverse events (AEs) during therapy. ARS scale showed a significant relationship between presence of anticholinergic medication and AEs. A large number of patients suffered anticholinergic events, with more events per patient in patients taking anticholinergic drugs. Conclusions: Older hepatitis C chronic patients are exposed to potentially inappropriate polypharmacy and anticholinergic risk, according to the ACB, ARS and ADS scales. The three scales showed different results. Only the ARS scale was associated with AEs, but the rate of anticholinergic effects per patient was significantly higher in patients with anticholinergic drugs, regardless of the scale used. Consider quality of pharmacotherapy when starting DAA with a multidisciplinary approach could improve health outcomes.

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Section: Discussionsupporting

confidence: 86%

Section: Exposure To Polypharmacy and Anticholinergic Medicationmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Anticholinergic Burden and Safety Outcomes in Older Patients with Chronic Hepatitis C: A Retrospective Cohort Study

Amoros-Reboredo

Soy

Hernández

et al. 2020

IJERPH

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“…Four papers used more than one ACB measure in their analysis. Sevilla-Sańchez et al (2018) used two measures, however one of these (DBI (total) ) was not anticholinergic-specific (see exclusion criteria). The data for this measure were therefore excluded from analysis.…”

Section: Resultsmentioning

confidence: 99%

“…,Mangoni et al (2013),Sarbacker et al (2017), andSevilla-Sańchez et al (2018). The total population size was 226,543 individuals, with sample sizes ranging from 71Mangoni et al (2013) to 224,740 Chatterjee et al (2017.…”

mentioning

confidence: 99%

The Prognostic Value of Anticholinergic Burden Measures in Relation to Mortality in Older Individuals: A Systematic Review and Meta-Analysis

et al. 2020

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Background: Greater anticholinergic burden (ACB) increases the risk of mortality in older individuals, yet the strength of this association varies between studies. One possible explanation for this variance is the use of different approaches to quantify ACB. This systematic review (PROSPERO number CRD42019115918) assessed the prognostic utility of ACB-specific measures on mortality in older individuals. Methods:Multiple cross-disciplinary databases were searched from 2006-2018. Observational studies assessing the association between ACB and mortality utilizing ≥1 ACB measure, involving persons aged ≥65 years were included. Screening and data extraction were performed by two independent reviewers, with disagreements resolved by a third independent reviewer. Risk of bias and quality of evidence were assessed using Quality in Prognosis Studies (QUIPS) and Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) criteria. Meta-analysis was conducted where appropriate.Results: Of 19,224 titles, 20 articles describing 18 cohort studies involving 498,056 older individuals were eligible. Eight anticholinergic-specific measures were identified; the Anticholinergic Cognitive Burden Scale (ACBS, n=9) and Anticholinergic Risk scale (ARS, n=8) were most frequently reported. The evidence base was of poor quality, with moderate to high risk of bias. Meta-analysis showed increased mortality risk.Conclusions: There was a modest association between some ACB measures and mortality, with most evidence derived from the ACBS. Studies comparing different measures within the same population were lacking. Analysis was limited by poor generalizability between studies, specifically regarding heterogeneity in methodology and reporting, as well as high risk of bias for most studies in the evidence base.

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Constipation‐associated factors in outpatients with schizophrenia: A multicenter questionnaire survey

Tazaki,

Yamada,

Sato

et al. 2024

Neuropsychopharm Rep

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Constipation is a prevalent gastrointestinal disorder that affects people globally, decreasing their quality of life and life expectancy. Individuals with schizophrenia often suffer from constipation, which could be a result of the illness itself or the side effects of psychotropic medications. However, little research has been conducted on factors contributing to constipation in individuals with schizophrenia. To address this issue, we conducted a survey using self‐administered questionnaires and medical records to identify factors associated with constipation in psychiatric outpatients. This study included 399 patients with schizophrenia, resulting in a high prevalence of constipation (43.4%). The analysis suggested that female gender, the doses of antiparkinsonian medications, and benzodiazepine sleeping pills may be associated with constipation.

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Prevalence, risk factors and adverse outcomes of anticholinergic burden in patients with advanced chronic conditions at hospital admission

Cited by 18 publications

References 28 publications

Anticholinergic Burden and Safety Outcomes in Older Patients with Chronic Hepatitis C: A Retrospective Cohort Study

Anticholinergic Burden and Safety Outcomes in Older Patients with Chronic Hepatitis C: A Retrospective Cohort Study

The Prognostic Value of Anticholinergic Burden Measures in Relation to Mortality in Older Individuals: A Systematic Review and Meta-Analysis

Constipation‐associated factors in outpatients with schizophrenia: A multicenter questionnaire survey

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