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Potentially Inappropriate Medications and Anticholinergic Burden in Older People Attending Memory Clinics in Australia.
Drugs Aging. 2016 Jan; 33(1):37-44.DA

Abstract

BACKGROUND

There has been limited research into potentially inappropriate medication (PIM) use and anticholinergic burden in patients attending memory clinics.

OBJECTIVES

The aim of this study was to explore the use of PIMs related to cognitive impairment (PIMcog), anticholinergic cognitive burden (ACB) and concomitant use of anticholinergic medications with cholinesterase inhibitors (ChEIs) in patients attending memory clinics.

METHODS

Cross-sectional analysis of baseline data from the Prospective Research In MEmory clinics (PRIME) study was performed. Participants were community-dwelling patients who attended nine memory clinics and had a diagnosis of mild cognitive impairment or dementia. PIMcog were defined as any medication considered potentially inappropriate for patients with cognitive impairment according to the Beers or STOPP criteria. Clinically significant ACB was defined as total score of ≥3 on the ACB scale.

RESULTS

A total of 964 patients, mean age 77.6 years, were included. PIMcog were used by 206 (21.4%) patients. Anticholinergics and sedatives were the most common PIMcog. PIMcog use was associated with higher number of medications (adjusted OR 1.26; 95% CI 1.19-1.33) and with not having completed secondary level education (adjusted OR 1.71; 95% CI 1.01-2.89). One hundred and thirteen (11.7%) patients had a clinically significant ACB score (≥3). ChEIs were used by 575 patients and 65 (11.3%) of these had an ACB score ≥3. There was no statistically significant difference in ChEI use between patients with and without an ACB score ≥3.

CONCLUSION

PIMcog use, clinically significant anticholinergic burden, and concurrent use of anticholinergics with ChEIs were prevalent in patients attending memory clinics. Efforts are needed to improve prescribing for people with cognitive impairment.

Authors+Show Affiliations

Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Parkville, VIC, Australia.Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Parkville, VIC, Australia.Medical and Cognitive Research Unit, Austin Health, Heidelberg, VIC, Australia.National Ageing Research Institute, Parkville, VIC, Australia. University of Melbourne Academic Unit for Psychiatry of Old Age, St George's Hospital, Kew, VIC, Australia.Dementia Collaborative Research Centre, School of Psychiatry, University of NSW, Sydney, NSW, Australia. Centre for Healthy Brain Ageing, School of Psychiatry, University of NSW, Sydney, NSW, Australia.Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Parkville, VIC, Australia.Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Parkville, VIC, Australia. rohan.elliott@austin.org.au. Pharmacy Department, Austin Health, PO Box 5555, Heidelberg, VIC, 3084, Australia. rohan.elliott@austin.org.au.

Pub Type(s)

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

Language

eng

PubMed ID

26645294

Citation

Cross, Amanda J., et al. "Potentially Inappropriate Medications and Anticholinergic Burden in Older People Attending Memory Clinics in Australia." Drugs & Aging, vol. 33, no. 1, 2016, pp. 37-44.
Cross AJ, George J, Woodward MC, et al. Potentially Inappropriate Medications and Anticholinergic Burden in Older People Attending Memory Clinics in Australia. Drugs Aging. 2016;33(1):37-44.
Cross, A. J., George, J., Woodward, M. C., Ames, D., Brodaty, H., Ilomäki, J., & Elliott, R. A. (2016). Potentially Inappropriate Medications and Anticholinergic Burden in Older People Attending Memory Clinics in Australia. Drugs & Aging, 33(1), 37-44. https://doi.org/10.1007/s40266-015-0332-3
Cross AJ, et al. Potentially Inappropriate Medications and Anticholinergic Burden in Older People Attending Memory Clinics in Australia. Drugs Aging. 2016;33(1):37-44. PubMed PMID: 26645294.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Potentially Inappropriate Medications and Anticholinergic Burden in Older People Attending Memory Clinics in Australia. AU - Cross,Amanda J, AU - George,Johnson, AU - Woodward,Michael C, AU - Ames,David, AU - Brodaty,Henry, AU - Ilomäki,Jenni, AU - Elliott,Rohan A, PY - 2015/12/10/entrez PY - 2015/12/10/pubmed PY - 2016/7/28/medline SP - 37 EP - 44 JF - Drugs & aging JO - Drugs Aging VL - 33 IS - 1 N2 - BACKGROUND: There has been limited research into potentially inappropriate medication (PIM) use and anticholinergic burden in patients attending memory clinics. OBJECTIVES: The aim of this study was to explore the use of PIMs related to cognitive impairment (PIMcog), anticholinergic cognitive burden (ACB) and concomitant use of anticholinergic medications with cholinesterase inhibitors (ChEIs) in patients attending memory clinics. METHODS: Cross-sectional analysis of baseline data from the Prospective Research In MEmory clinics (PRIME) study was performed. Participants were community-dwelling patients who attended nine memory clinics and had a diagnosis of mild cognitive impairment or dementia. PIMcog were defined as any medication considered potentially inappropriate for patients with cognitive impairment according to the Beers or STOPP criteria. Clinically significant ACB was defined as total score of ≥3 on the ACB scale. RESULTS: A total of 964 patients, mean age 77.6 years, were included. PIMcog were used by 206 (21.4%) patients. Anticholinergics and sedatives were the most common PIMcog. PIMcog use was associated with higher number of medications (adjusted OR 1.26; 95% CI 1.19-1.33) and with not having completed secondary level education (adjusted OR 1.71; 95% CI 1.01-2.89). One hundred and thirteen (11.7%) patients had a clinically significant ACB score (≥3). ChEIs were used by 575 patients and 65 (11.3%) of these had an ACB score ≥3. There was no statistically significant difference in ChEI use between patients with and without an ACB score ≥3. CONCLUSION: PIMcog use, clinically significant anticholinergic burden, and concurrent use of anticholinergics with ChEIs were prevalent in patients attending memory clinics. Efforts are needed to improve prescribing for people with cognitive impairment. SN - 1179-1969 UR - https://www.unboundmedicine.com/medline/citation/26645294/Potentially_Inappropriate_Medications_and_Anticholinergic_Burden_in_Older_People_Attending_Memory_Clinics_in_Australia_ DB - PRIME DP - Unbound Medicine ER -