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Clinical and demographic factors associated with antimuscarinic medication use in older hospitalized patients.
Hosp Pract (1995). 2011 Feb; 39(1):30-6.HP

Abstract

BACKGROUND

Antimuscarinic drug prescribing scoring systems might better identify patients at risk of adverse drug reactions. The recently developed Anticholinergic Risk Scale (ARS) score is significantly associated with the number of antimuscarinic side effects in older outpatients. We sought to identify the clinical and demographic patient-level correlates of the ARS, including a modified version adjusted for daily dose, in elderly hospitalized patients.

METHODS

Clinical and demographic patient characteristics known to be associated with antimuscarinic prescribing, ARS and dose-adjusted ARS scores, and full medication exposure on admission were recorded in 362 consecutive patients (aged 83.6 ± 6.6 years) admitted to 2 geriatric units (NHS Grampian, Aberdeen, Scotland, UK) between February 1, 2010 and June 30, 2010.

RESULTS

Each year of increasing age was associated with reduced number of antimuscarinic drugs (incidence rate ratio [IRR], 0.963; 95% confidence interval [CI], 0.948-0.980; P < 0.001), non-antimuscarinic drugs (IRR, 0.991; 95% CI, 0.985-0.997; P = 0.006), and total number of drugs (IRR, 0.988; 95% CI, 0.983-0.994; P < 0.001). Multivariate Poisson regression showed that increasing age and history of dementia were negatively associated with the ARS score (IRR, 0.97; 95% CI, 0.94-0.99; P = 0.001 and IRR, 0.62; 95% CI, 0.41-0.92; P = 0.019, respectively). By contrast, institutionalization (IRR, 1.32; 95% CI, 1.00-1.74; P = 0.050), Charlson comorbidity index (IRR, 1.06; 95% CI, 1.01-1.11; P = 0.015), and total number of non-antimuscarinic drugs (IRR, 1.13; 95% CI, 1.08-1.18; P < 0.001) were all positively associated with the ARS score. Similar results were observed for the dose-adjusted ARS score.

CONCLUSION

Institutionalization, comorbidities, and non-antimuscarinic polypharmacy show independent positive associations with the ARS and dose-adjusted ARS scores in older hospitalized patients. Increasing age and dementia are negatively associated with the ARS score.

Authors+Show Affiliations

Division of Applied Medicine, University of Aberdeen, Aberdeen, Scotland, United Kingdom.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

21441756

Citation

Lowry, Estelle, et al. "Clinical and Demographic Factors Associated With Antimuscarinic Medication Use in Older Hospitalized Patients." Hospital Practice (1995), vol. 39, no. 1, 2011, pp. 30-6.
Lowry E, Woodman RJ, Soiza RL, et al. Clinical and demographic factors associated with antimuscarinic medication use in older hospitalized patients. Hosp Pract (1995). 2011;39(1):30-6.
Lowry, E., Woodman, R. J., Soiza, R. L., & Mangoni, A. A. (2011). Clinical and demographic factors associated with antimuscarinic medication use in older hospitalized patients. Hospital Practice (1995), 39(1), 30-6. https://doi.org/10.3810/hp.2011.02.371
Lowry E, et al. Clinical and Demographic Factors Associated With Antimuscarinic Medication Use in Older Hospitalized Patients. Hosp Pract (1995). 2011;39(1):30-6. PubMed PMID: 21441756.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Clinical and demographic factors associated with antimuscarinic medication use in older hospitalized patients. AU - Lowry,Estelle, AU - Woodman,Richard J, AU - Soiza,Roy L, AU - Mangoni,Arduino A, PY - 2011/3/29/entrez PY - 2011/3/29/pubmed PY - 2011/6/3/medline SP - 30 EP - 6 JF - Hospital practice (1995) JO - Hosp Pract (1995) VL - 39 IS - 1 N2 - BACKGROUND: Antimuscarinic drug prescribing scoring systems might better identify patients at risk of adverse drug reactions. The recently developed Anticholinergic Risk Scale (ARS) score is significantly associated with the number of antimuscarinic side effects in older outpatients. We sought to identify the clinical and demographic patient-level correlates of the ARS, including a modified version adjusted for daily dose, in elderly hospitalized patients. METHODS: Clinical and demographic patient characteristics known to be associated with antimuscarinic prescribing, ARS and dose-adjusted ARS scores, and full medication exposure on admission were recorded in 362 consecutive patients (aged 83.6 ± 6.6 years) admitted to 2 geriatric units (NHS Grampian, Aberdeen, Scotland, UK) between February 1, 2010 and June 30, 2010. RESULTS: Each year of increasing age was associated with reduced number of antimuscarinic drugs (incidence rate ratio [IRR], 0.963; 95% confidence interval [CI], 0.948-0.980; P < 0.001), non-antimuscarinic drugs (IRR, 0.991; 95% CI, 0.985-0.997; P = 0.006), and total number of drugs (IRR, 0.988; 95% CI, 0.983-0.994; P < 0.001). Multivariate Poisson regression showed that increasing age and history of dementia were negatively associated with the ARS score (IRR, 0.97; 95% CI, 0.94-0.99; P = 0.001 and IRR, 0.62; 95% CI, 0.41-0.92; P = 0.019, respectively). By contrast, institutionalization (IRR, 1.32; 95% CI, 1.00-1.74; P = 0.050), Charlson comorbidity index (IRR, 1.06; 95% CI, 1.01-1.11; P = 0.015), and total number of non-antimuscarinic drugs (IRR, 1.13; 95% CI, 1.08-1.18; P < 0.001) were all positively associated with the ARS score. Similar results were observed for the dose-adjusted ARS score. CONCLUSION: Institutionalization, comorbidities, and non-antimuscarinic polypharmacy show independent positive associations with the ARS and dose-adjusted ARS scores in older hospitalized patients. Increasing age and dementia are negatively associated with the ARS score. SN - 2154-8331 UR - https://www.unboundmedicine.com/medline/citation/21441756/Clinical_and_demographic_factors_associated_with_antimuscarinic_medication_use_in_older_hospitalized_patients_ DB - PRIME DP - Unbound Medicine ER -