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Systematic review on the use of anticholinergic scales in poly pathological patients.
Arch Gerontol Geriatr. 2016 Jan-Feb; 62:1-8.AG

Abstract

PURPOSE

Anticholinergic drugs may increase the risk of cognitive and functional disorders in older patients. There are anticholinergic scales on which said risk is estimated. The objectives of this study are: to identify the scales described in literature that are applicable to polypathological patients and analyze their clinical outcomes.

MATERIAL AND METHODS

A systematic review was performed. Data sources were MEDLINE, EMBASE and Web of Science which were consulted until August 2014.

INCLUSION CRITERIA

(1) studies that specify the list of drugs, describe the methodology for their elaboration and how they calibrate the anticholinergic potential and (2) studies that use the scales identified as a tool to measure exposure to anticholinergic drugs in polypathological patients or those with similar characteristics. The main differences between the scales and main results on cognitive, functional and mortality status were collected.

RESULTS

25 articles were included. 10 scales were identified. For their preparation, 8 were based on literature about drugs with anticholinergic activity and/or previously published scales as well as expert opinions. Exposure to anticholinergic drugs has been linked to cognitive disorders (basically measured with Anticholinergic Risk Scale (ARS), Anticholinergic Cognitive Burden Scale (ACB) and Drug Burden Index (DBI)) and functional scale (with ARS and DBI). However, there is no clear relationship with mortality. The Anticholinergic Drug Scale was the only one that obtained no association with any of the variables studied.

CONCLUSIONS

There is a great variety of scales published and applied to older patients. The clinical results are different depending on the scale used which is probably due to the different methodology in their elaboration.

Authors+Show Affiliations

Pharmacy Service, University Hospital Virgen del Rocio, Seville, Spain. Electronic address: angelavm_21@hotmail.com.Andalusian Agency for Health Technology Assessment, Seville, Spain.Department of Pharmacology, Faculty of Pharmacy, Seville, Spain.Internal Medicine Service, University Hospital Virgen del Rocio, Seville, Spain.Pharmacy Service, University Hospital Virgen de Valme, Seville, Spain.

Pub Type(s)

Journal Article
Review
Systematic Review

Language

eng

PubMed ID

26518612

Citation

Villalba-Moreno, Angela Maria, et al. "Systematic Review On the Use of Anticholinergic Scales in Poly Pathological Patients." Archives of Gerontology and Geriatrics, vol. 62, 2016, pp. 1-8.
Villalba-Moreno AM, Alfaro-Lara ER, Pérez-Guerrero MC, et al. Systematic review on the use of anticholinergic scales in poly pathological patients. Arch Gerontol Geriatr. 2016;62:1-8.
Villalba-Moreno, A. M., Alfaro-Lara, E. R., Pérez-Guerrero, M. C., Nieto-Martín, M. D., & Santos-Ramos, B. (2016). Systematic review on the use of anticholinergic scales in poly pathological patients. Archives of Gerontology and Geriatrics, 62, 1-8. https://doi.org/10.1016/j.archger.2015.10.002
Villalba-Moreno AM, et al. Systematic Review On the Use of Anticholinergic Scales in Poly Pathological Patients. Arch Gerontol Geriatr. 2016 Jan-Feb;62:1-8. PubMed PMID: 26518612.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Systematic review on the use of anticholinergic scales in poly pathological patients. AU - Villalba-Moreno,Angela Maria, AU - Alfaro-Lara,Eva Rocío, AU - Pérez-Guerrero,Maria Concepción, AU - Nieto-Martín,Maria Dolores, AU - Santos-Ramos,Bernardo, Y1 - 2015/10/14/ PY - 2015/06/18/received PY - 2015/10/04/revised PY - 2015/10/05/accepted PY - 2015/11/1/entrez PY - 2015/11/1/pubmed PY - 2016/4/5/medline KW - Anticholinergic drugs KW - Chronic patients KW - Cognition disorders KW - Multimorbidity KW - Polypathological patient KW - Scales SP - 1 EP - 8 JF - Archives of gerontology and geriatrics JO - Arch Gerontol Geriatr VL - 62 N2 - PURPOSE: Anticholinergic drugs may increase the risk of cognitive and functional disorders in older patients. There are anticholinergic scales on which said risk is estimated. The objectives of this study are: to identify the scales described in literature that are applicable to polypathological patients and analyze their clinical outcomes. MATERIAL AND METHODS: A systematic review was performed. Data sources were MEDLINE, EMBASE and Web of Science which were consulted until August 2014. INCLUSION CRITERIA: (1) studies that specify the list of drugs, describe the methodology for their elaboration and how they calibrate the anticholinergic potential and (2) studies that use the scales identified as a tool to measure exposure to anticholinergic drugs in polypathological patients or those with similar characteristics. The main differences between the scales and main results on cognitive, functional and mortality status were collected. RESULTS: 25 articles were included. 10 scales were identified. For their preparation, 8 were based on literature about drugs with anticholinergic activity and/or previously published scales as well as expert opinions. Exposure to anticholinergic drugs has been linked to cognitive disorders (basically measured with Anticholinergic Risk Scale (ARS), Anticholinergic Cognitive Burden Scale (ACB) and Drug Burden Index (DBI)) and functional scale (with ARS and DBI). However, there is no clear relationship with mortality. The Anticholinergic Drug Scale was the only one that obtained no association with any of the variables studied. CONCLUSIONS: There is a great variety of scales published and applied to older patients. The clinical results are different depending on the scale used which is probably due to the different methodology in their elaboration. SN - 1872-6976 UR - https://www.unboundmedicine.com/medline/citation/26518612/Systematic_review_on_the_use_of_anticholinergic_scales_in_poly_pathological_patients_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0167-4943(15)30066-2 DB - PRIME DP - Unbound Medicine ER -