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Prescription patterns of anticholinergic agents and their associated factors in Korean elderly patients with dementia.
Int J Clin Pharm. 2013 Oct; 35(5):711-8.IJ

Abstract

BACKGROUND

Dementia is a disorder that is characterized by a chronic, progressive loss of cognitive function. Anticholinergic agents that are often used with elderly patients may cause a decline in cognitive capacity; therefore, they must be used with caution.

OBJECTIVE

We aimed to identify the prescription patterns for anticholinergic drugs in elderly outpatients with a documented diagnosis of dementia through a retrospective analysis of electronic medical records. In addition, the study aimed to identify factors influencing these prescription patterns.

SETTING

The Kyung Hee University Hospital in Korea.

METHODS

We studied outpatients aged ≥ 65 years registered with dementia between January 1, 2011 and December 31, 2011. We reviewed prescription histories, identified anticholinergic prescriptions during the study period using the anticholinergic risk scale (ARS), and examined prescription patterns in the subjects. After analysing the ARS scores for each drug and subject, we performed a statistical analysis of the factors affecting prescription patterns for anticholinergic medications in patients with ARS scores of ≥ 2.

MAIN OUTCOME MEASURE

Prescription data on anticholinergic agents.

RESULTS

Of 773 elderly dementia patients, 362 patients (46.83 %) were prescribed at least one anticholinergic medication. Of the ARS 2-point anticholinergics, nortriptyline was prescribed most frequently. Among ARS 3-point anticholinergics, cyproheptadine was prescribed most frequently. An ARS score of ≥ 2 was given in 255 (32.98 %) patients. A multivariate logistic regression analysis of the factors associated with anticholinergic prescription patterns revealed that those patients with comorbid Parkinson's disease received significantly fewer prescriptions (OR = 0.544; 95% CI 0.364-0.813) and those patients who were prescribed 6-10 or ≥ 11 medications were significantly more likely to receive anticholinergic prescriptions (OR = 3.410; 95 % CI 2.228-5.220 and OR = 4.688; 95 % CI 2.993-7.344, respectively).

CONCLUSION

Approximately 33% of the elderly dementia patients in this study were prescribed clinically significant medication regimens totaling an ARS score of ≥ 2. Our findings show that the total number of medications and comorbid Parkinson's disease both influence prescription patterns for anticholinergic medications.

Authors+Show Affiliations

Department of Pharmacy, Kyung Hee University Hospital, Seoul, Korea.No affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

23708883

Citation

Lee, Eun Kyung, and Yu Jeung Lee. "Prescription Patterns of Anticholinergic Agents and Their Associated Factors in Korean Elderly Patients With Dementia." International Journal of Clinical Pharmacy, vol. 35, no. 5, 2013, pp. 711-8.
Lee EK, Lee YJ. Prescription patterns of anticholinergic agents and their associated factors in Korean elderly patients with dementia. Int J Clin Pharm. 2013;35(5):711-8.
Lee, E. K., & Lee, Y. J. (2013). Prescription patterns of anticholinergic agents and their associated factors in Korean elderly patients with dementia. International Journal of Clinical Pharmacy, 35(5), 711-8. https://doi.org/10.1007/s11096-013-9793-9
Lee EK, Lee YJ. Prescription Patterns of Anticholinergic Agents and Their Associated Factors in Korean Elderly Patients With Dementia. Int J Clin Pharm. 2013;35(5):711-8. PubMed PMID: 23708883.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prescription patterns of anticholinergic agents and their associated factors in Korean elderly patients with dementia. AU - Lee,Eun Kyung, AU - Lee,Yu Jeung, Y1 - 2013/05/25/ PY - 2012/07/27/received PY - 2013/05/11/accepted PY - 2013/5/28/entrez PY - 2013/5/28/pubmed PY - 2014/5/27/medline SP - 711 EP - 8 JF - International journal of clinical pharmacy JO - Int J Clin Pharm VL - 35 IS - 5 N2 - BACKGROUND: Dementia is a disorder that is characterized by a chronic, progressive loss of cognitive function. Anticholinergic agents that are often used with elderly patients may cause a decline in cognitive capacity; therefore, they must be used with caution. OBJECTIVE: We aimed to identify the prescription patterns for anticholinergic drugs in elderly outpatients with a documented diagnosis of dementia through a retrospective analysis of electronic medical records. In addition, the study aimed to identify factors influencing these prescription patterns. SETTING: The Kyung Hee University Hospital in Korea. METHODS: We studied outpatients aged ≥ 65 years registered with dementia between January 1, 2011 and December 31, 2011. We reviewed prescription histories, identified anticholinergic prescriptions during the study period using the anticholinergic risk scale (ARS), and examined prescription patterns in the subjects. After analysing the ARS scores for each drug and subject, we performed a statistical analysis of the factors affecting prescription patterns for anticholinergic medications in patients with ARS scores of ≥ 2. MAIN OUTCOME MEASURE: Prescription data on anticholinergic agents. RESULTS: Of 773 elderly dementia patients, 362 patients (46.83 %) were prescribed at least one anticholinergic medication. Of the ARS 2-point anticholinergics, nortriptyline was prescribed most frequently. Among ARS 3-point anticholinergics, cyproheptadine was prescribed most frequently. An ARS score of ≥ 2 was given in 255 (32.98 %) patients. A multivariate logistic regression analysis of the factors associated with anticholinergic prescription patterns revealed that those patients with comorbid Parkinson's disease received significantly fewer prescriptions (OR = 0.544; 95% CI 0.364-0.813) and those patients who were prescribed 6-10 or ≥ 11 medications were significantly more likely to receive anticholinergic prescriptions (OR = 3.410; 95 % CI 2.228-5.220 and OR = 4.688; 95 % CI 2.993-7.344, respectively). CONCLUSION: Approximately 33% of the elderly dementia patients in this study were prescribed clinically significant medication regimens totaling an ARS score of ≥ 2. Our findings show that the total number of medications and comorbid Parkinson's disease both influence prescription patterns for anticholinergic medications. SN - 2210-7711 UR - https://www.unboundmedicine.com/medline/citation/23708883/Prescription_patterns_of_anticholinergic_agents_and_their_associated_factors_in_Korean_elderly_patients_with_dementia_ L2 - https://dx.doi.org/10.1007/s11096-013-9793-9 DB - PRIME DP - Unbound Medicine ER -