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Simultaneous usage of dementia medications and anticholinergics among Asians and Pacific Islanders.
Psychogeriatrics. 2017 Nov; 17(6):423-429.P

Abstract

BACKGROUND

The simultaneous use of dementia medications and anticholinergic medications occurs frequently. Cholinesterase inhibitors and anticholinergic medications likely counteract one another, potentially exposing patients to medications with decreased benefit, more adverse effects, and higher cost of care. We identified the rate of concurrent prescriptions of cholinesterase inhibitors/memantine with anticholinergics in an urban hospital setting with a large Asian and Pacific Islander population.

METHODS

This study is a retrospective review of patients hospitalized from 1 January 2006 to 31 December 2010 at a general hospital who simultaneously received US Food and Drug Administration-approved dementia medications (galantamine, rivastigmine, donepezil, and/or memantine) and anticholinergics.

RESULTS

Overall, 304 patients receiving cholinesterase inhibitors/memantine also received anticholinergics. Of these patients, 64.1% were given high-potency anticholinergic medications, and 35.9% received medium-potency medications. Indications for the use of anticholinergic medication were urological (17.8%), gastrointestinal excluding nausea (32.6%), nausea (10.2%), psychiatric (7.9%), and other (31.6%). Asian patients received the combination of cholinesterase inhibitors/memantine and anticholinergics less frequently than Native Hawaiian or Caucasian patients (8.4% vs 12.2% and 13.3%, respectively; χ2 = 16.04, degrees of freedom = 2, P < 0.0003).

CONCLUSIONS

Simultaneous prescribing of cholinesterase inhibitors, memantine, and anticholinergic medications was significantly less common than in previous studies, with some ethnic variability. The less frequent occurrence of concurrent medications in the Asian population may be because of variations in the rate of indications or in tolerability for anticholinergic medications among the population.

Authors+Show Affiliations

Department of Psychiatry, John A. Burns School of Medicine, University of Hawaii, Honolulu, Hawaii, USA. The Queen's Medical Center, Honolulu, Hawaii, USA.Department of Psychiatry, John A. Burns School of Medicine, University of Hawaii, Honolulu, Hawaii, USA. The Queen's Medical Center, Honolulu, Hawaii, USA.Department of Psychiatry, John A. Burns School of Medicine, University of Hawaii, Honolulu, Hawaii, USA. The Queen's Medical Center, Honolulu, Hawaii, USA.Princeton University, Princeton, New Jersey, USA.Department of Psychiatry, John A. Burns School of Medicine, University of Hawaii, Honolulu, Hawaii, USA. The Queen's Medical Center, Honolulu, Hawaii, USA.The Queen's Medical Center, Honolulu, Hawaii, USA. Department of Cell and Molecular Biology, University of Hawaii, Honolulu, Hawaii, USA.Department of Psychiatry, John A. Burns School of Medicine, University of Hawaii, Honolulu, Hawaii, USA.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

28387023

Citation

Schultz, Brian R., et al. "Simultaneous Usage of Dementia Medications and Anticholinergics Among Asians and Pacific Islanders." Psychogeriatrics : the Official Journal of the Japanese Psychogeriatric Society, vol. 17, no. 6, 2017, pp. 423-429.
Schultz BR, Takeshita J, Goebert D, et al. Simultaneous usage of dementia medications and anticholinergics among Asians and Pacific Islanders. Psychogeriatrics. 2017;17(6):423-429.
Schultz, B. R., Takeshita, J., Goebert, D., Takeshita, S., Lu, B. Y., Guilloux, A., & Higa, J. (2017). Simultaneous usage of dementia medications and anticholinergics among Asians and Pacific Islanders. Psychogeriatrics : the Official Journal of the Japanese Psychogeriatric Society, 17(6), 423-429. https://doi.org/10.1111/psyg.12267
Schultz BR, et al. Simultaneous Usage of Dementia Medications and Anticholinergics Among Asians and Pacific Islanders. Psychogeriatrics. 2017;17(6):423-429. PubMed PMID: 28387023.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Simultaneous usage of dementia medications and anticholinergics among Asians and Pacific Islanders. AU - Schultz,Brian R, AU - Takeshita,Junji, AU - Goebert,Deborah, AU - Takeshita,Steven, AU - Lu,Brett Y, AU - Guilloux,Alexandre, AU - Higa,Joy, Y1 - 2017/04/07/ PY - 2016/05/26/received PY - 2017/02/10/revised PY - 2017/02/17/accepted PY - 2017/4/8/pubmed PY - 2018/1/20/medline PY - 2017/4/8/entrez KW - Asian Continental Ancestry Group KW - cholinergic antagonists KW - cholinesterase inhibitors KW - dementia KW - memantine SP - 423 EP - 429 JF - Psychogeriatrics : the official journal of the Japanese Psychogeriatric Society JO - Psychogeriatrics VL - 17 IS - 6 N2 - BACKGROUND: The simultaneous use of dementia medications and anticholinergic medications occurs frequently. Cholinesterase inhibitors and anticholinergic medications likely counteract one another, potentially exposing patients to medications with decreased benefit, more adverse effects, and higher cost of care. We identified the rate of concurrent prescriptions of cholinesterase inhibitors/memantine with anticholinergics in an urban hospital setting with a large Asian and Pacific Islander population. METHODS: This study is a retrospective review of patients hospitalized from 1 January 2006 to 31 December 2010 at a general hospital who simultaneously received US Food and Drug Administration-approved dementia medications (galantamine, rivastigmine, donepezil, and/or memantine) and anticholinergics. RESULTS: Overall, 304 patients receiving cholinesterase inhibitors/memantine also received anticholinergics. Of these patients, 64.1% were given high-potency anticholinergic medications, and 35.9% received medium-potency medications. Indications for the use of anticholinergic medication were urological (17.8%), gastrointestinal excluding nausea (32.6%), nausea (10.2%), psychiatric (7.9%), and other (31.6%). Asian patients received the combination of cholinesterase inhibitors/memantine and anticholinergics less frequently than Native Hawaiian or Caucasian patients (8.4% vs 12.2% and 13.3%, respectively; χ2 = 16.04, degrees of freedom = 2, P < 0.0003). CONCLUSIONS: Simultaneous prescribing of cholinesterase inhibitors, memantine, and anticholinergic medications was significantly less common than in previous studies, with some ethnic variability. The less frequent occurrence of concurrent medications in the Asian population may be because of variations in the rate of indications or in tolerability for anticholinergic medications among the population. SN - 1479-8301 UR - https://www.unboundmedicine.com/medline/citation/28387023/Simultaneous_usage_of_dementia_medications_and_anticholinergics_among_Asians_and_Pacific_Islanders_ L2 - https://doi.org/10.1111/psyg.12267 DB - PRIME DP - Unbound Medicine ER -