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Measuring anticholinergic drug exposure in older community-dwelling Australian men: a comparison of four different measures.
Br J Clin Pharmacol. 2015 Nov; 80(5):1169-75.BJ

Abstract

AIMS

Anticholinergic drug exposure is associated with adverse outcomes in older people. While a number of tools have been developed to measure anticholinergic drug exposure, there is limited information about the agreement and overlap between the various scales. The aim of this study was to investigate the agreement and overlap between different measures of anticholinergic drug exposure in a cohort of community-dwelling older men.

METHODS

A cross-sectional study was used to compare anticholinergic drug exposure calculated using the Anticholinergic Risk Scale (ARS), the Anticholinergic Drug Scale (ADS), the Anticholinergic Cognitive Burden (ACB) and the Drug Burden Index anticholinergic subscale (DBI-ACH) in a cohort of community-dwelling men aged 70 years and older (n = 1696). Statistical agreement, expressed as Cohen's kappa (κ), between these measurements was calculated.

RESULTS

Differences were found between the tools regarding the classification of anticholinergic drug exposure for individual participants. Thirteen percent of the population used a drug listed as anticholinergic on the ARS, 39% used a drug listed on the ADS and the ACB, and 18% of the population used one or more anticholinergic drugs listed on the DBI-ACH. While agreement was good between the ACB and ADS (κ = 0.628, 95% CI 0.593, 0.664), little agreement was found between remaining tools (κ = 0.091-0.264).

CONCLUSIONS

With the exception of the ACB and ADS, there was poor agreement regarding anticholinergic drug exposure among the four tools compared in this study. Great care should be taken when interpreting anticholinergic drug exposure using existing scales due to the wide variability between the different scales.

Authors+Show Affiliations

Australian Institute of Health Innovation, Macquarie University, North Ryde, Australia. Sydney Nursing School, University of Sydney, Sydney, Australia.Department of Pharmacy, University of Groningen, Groningen, The Netherlands. Department of Clinical Pharmacology & Toxicology, Maastricht UMC+, Maastricht, The Netherlands. Department of Epidemiology, CAPHRI School of Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands.Faculty of Pharmacy, University of Sydney, Sydney, Australia. Centre for Education and Research on Ageing, University of Sydney and Concord Hospital, Sydney, Australia.Faculty of Pharmacy, University of Sydney, Sydney, Australia. Centre for Education and Research on Ageing, University of Sydney and Concord Hospital, Sydney, Australia.Department of Urology, Concord Repatriation General Hospital, Sydney, Australia.Centre for Education and Research on Ageing, University of Sydney and Concord Hospital, Sydney, Australia. School of Public Health, University of Sydney, Sydney, Australia.Department of Pharmacy, University of Groningen, Groningen, The Netherlands.

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

25923961

Citation

Pont, Lisa G., et al. "Measuring Anticholinergic Drug Exposure in Older Community-dwelling Australian Men: a Comparison of Four Different Measures." British Journal of Clinical Pharmacology, vol. 80, no. 5, 2015, pp. 1169-75.
Pont LG, Nielen JT, McLachlan AJ, et al. Measuring anticholinergic drug exposure in older community-dwelling Australian men: a comparison of four different measures. Br J Clin Pharmacol. 2015;80(5):1169-75.
Pont, L. G., Nielen, J. T., McLachlan, A. J., Gnjidic, D., Chan, L., Cumming, R. G., & Taxis, K. (2015). Measuring anticholinergic drug exposure in older community-dwelling Australian men: a comparison of four different measures. British Journal of Clinical Pharmacology, 80(5), 1169-75. https://doi.org/10.1111/bcp.12670
Pont LG, et al. Measuring Anticholinergic Drug Exposure in Older Community-dwelling Australian Men: a Comparison of Four Different Measures. Br J Clin Pharmacol. 2015;80(5):1169-75. PubMed PMID: 25923961.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Measuring anticholinergic drug exposure in older community-dwelling Australian men: a comparison of four different measures. AU - Pont,Lisa G, AU - Nielen,Johannes T H, AU - McLachlan,Andrew J, AU - Gnjidic,Danijela, AU - Chan,Lewis, AU - Cumming,Robert G, AU - Taxis,Katja, Y1 - 2015/07/06/ PY - 2014/12/15/received PY - 2015/04/08/revised PY - 2015/04/10/accepted PY - 2015/4/30/entrez PY - 2015/4/30/pubmed PY - 2016/9/13/medline KW - anticholinergic burden KW - anticholinergic drug exposure KW - drug utilization KW - methodology KW - older people SP - 1169 EP - 75 JF - British journal of clinical pharmacology JO - Br J Clin Pharmacol VL - 80 IS - 5 N2 - AIMS: Anticholinergic drug exposure is associated with adverse outcomes in older people. While a number of tools have been developed to measure anticholinergic drug exposure, there is limited information about the agreement and overlap between the various scales. The aim of this study was to investigate the agreement and overlap between different measures of anticholinergic drug exposure in a cohort of community-dwelling older men. METHODS: A cross-sectional study was used to compare anticholinergic drug exposure calculated using the Anticholinergic Risk Scale (ARS), the Anticholinergic Drug Scale (ADS), the Anticholinergic Cognitive Burden (ACB) and the Drug Burden Index anticholinergic subscale (DBI-ACH) in a cohort of community-dwelling men aged 70 years and older (n = 1696). Statistical agreement, expressed as Cohen's kappa (κ), between these measurements was calculated. RESULTS: Differences were found between the tools regarding the classification of anticholinergic drug exposure for individual participants. Thirteen percent of the population used a drug listed as anticholinergic on the ARS, 39% used a drug listed on the ADS and the ACB, and 18% of the population used one or more anticholinergic drugs listed on the DBI-ACH. While agreement was good between the ACB and ADS (κ = 0.628, 95% CI 0.593, 0.664), little agreement was found between remaining tools (κ = 0.091-0.264). CONCLUSIONS: With the exception of the ACB and ADS, there was poor agreement regarding anticholinergic drug exposure among the four tools compared in this study. Great care should be taken when interpreting anticholinergic drug exposure using existing scales due to the wide variability between the different scales. SN - 1365-2125 UR - https://www.unboundmedicine.com/medline/citation/25923961/Measuring_anticholinergic_drug_exposure_in_older_community_dwelling_Australian_men:_a_comparison_of_four_different_measures_ L2 - https://doi.org/10.1111/bcp.12670 DB - PRIME DP - Unbound Medicine ER -