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Impact of anticholinergic burden on emergency department visits among older adults in Korea: A national population cohort study.
Arch Gerontol Geriatr. 2019 Nov - Dec; 85:103912.AG

Abstract

OBJECTIVES

This study aimed to evaluate the impact of high anticholinergic burden on overall emergency department (ED) visits and ED visits related to adverse effects of anticholinergic drugs among older adults.

METHODS

For this retrospective cohort study, we used claims data from older adults with high representativeness. The average daily Anticholinergic Risk Scale (ARS) score was calculated based on the dosage, treatment duration, and potency of anticholinergic drugs during three months. A high-exposure group (ARS ≥ 2) and a non-exposure group were included in this analysis. The primary outcome was the first ED visit during the follow-up period. Anticholinergic ED visits were defined as ED visits with a main diagnosis of a fall, fracture, dizziness, delirium, constipation, or urinary retention.

RESULTS

In total, 118,750 subjects (43.6% male) were included in this study. The mean age was 75.4 ± 6.6 years. The adjusted hazard ratios (aHRs) for all-cause and anticholinergic ED visits among those with high ARS scores were 1.28 (95% CI: 1.20-1.36) and 1.55 (95% CI: 1.38-1.74), respectively. The high-exposure group was at higher risk than the non-exposure group for ED visits for falls or fractures (aHR: 1.31, 95% CI: 1.07-1.60), dizziness (aHR: 1.71, 95% CI: 1.36-2.14), delirium (aHR: 2.05, 95% CI: 1.13-3.73), constipation (aHR: 1.65, 95% CI: 1.35-2.02) and urinary retention (aHR: 1.66, 95% CI: 1.30-2.12).

CONCLUSIONS

This study demonstrated that a high anticholinergic burden in older adults increased the risk of all-cause ED visits, anticholinergic ED visits and specific-cause ED visits.

Authors+Show Affiliations

College of Pharmacy and Institute of Pharmaceutical Science and Technology, Hanyang University, Ansan, Gyeonggi-do, Republic of Korea.College of Pharmacy and Research Institute of Pharmaceutical Sciences, Seoul National University, Seoul, Republic of Korea.College of Pharmacy, Yeungnam University, Gyeongsangbuk-do, Republic of Korea.College of Pharmacy, Yonsei University, Incheon, Republic of Korea.College of Pharmacy and Institute of Pharmaceutical Science and Technology, Hanyang University, Ansan, Gyeonggi-do, Republic of Korea. Electronic address: jechung@hanyang.ac.kr.College of Pharmacy and Research Institute of Pharmaceutical Sciences, Seoul National University, Seoul, Republic of Korea. Electronic address: jypharm@snu.ac.kr.

Pub Type(s)

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

Language

eng

PubMed ID

31386937

Citation

Hwang, Sunghee, et al. "Impact of Anticholinergic Burden On Emergency Department Visits Among Older Adults in Korea: a National Population Cohort Study." Archives of Gerontology and Geriatrics, vol. 85, 2019, p. 103912.
Hwang S, Jun K, Ah YM, et al. Impact of anticholinergic burden on emergency department visits among older adults in Korea: A national population cohort study. Arch Gerontol Geriatr. 2019;85:103912.
Hwang, S., Jun, K., Ah, Y. M., Han, E., Chung, J. E., & Lee, J. Y. (2019). Impact of anticholinergic burden on emergency department visits among older adults in Korea: A national population cohort study. Archives of Gerontology and Geriatrics, 85, 103912. https://doi.org/10.1016/j.archger.2019.103912
Hwang S, et al. Impact of Anticholinergic Burden On Emergency Department Visits Among Older Adults in Korea: a National Population Cohort Study. Arch Gerontol Geriatr. 2019 Nov - Dec;85:103912. PubMed PMID: 31386937.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Impact of anticholinergic burden on emergency department visits among older adults in Korea: A national population cohort study. AU - Hwang,Sunghee, AU - Jun,Kwanghee, AU - Ah,Young-Mi, AU - Han,Euna, AU - Chung,Jee Eun, AU - Lee,Ju-Yeun, Y1 - 2019/07/10/ PY - 2019/04/23/received PY - 2019/06/20/revised PY - 2019/07/09/accepted PY - 2019/8/7/pubmed PY - 2020/4/22/medline PY - 2019/8/7/entrez KW - Adverse effects KW - Cholinergic antagonists KW - Emergency department KW - Geriatrics KW - Insurance claims analyses SP - 103912 EP - 103912 JF - Archives of gerontology and geriatrics JO - Arch Gerontol Geriatr VL - 85 N2 - OBJECTIVES: This study aimed to evaluate the impact of high anticholinergic burden on overall emergency department (ED) visits and ED visits related to adverse effects of anticholinergic drugs among older adults. METHODS: For this retrospective cohort study, we used claims data from older adults with high representativeness. The average daily Anticholinergic Risk Scale (ARS) score was calculated based on the dosage, treatment duration, and potency of anticholinergic drugs during three months. A high-exposure group (ARS ≥ 2) and a non-exposure group were included in this analysis. The primary outcome was the first ED visit during the follow-up period. Anticholinergic ED visits were defined as ED visits with a main diagnosis of a fall, fracture, dizziness, delirium, constipation, or urinary retention. RESULTS: In total, 118,750 subjects (43.6% male) were included in this study. The mean age was 75.4 ± 6.6 years. The adjusted hazard ratios (aHRs) for all-cause and anticholinergic ED visits among those with high ARS scores were 1.28 (95% CI: 1.20-1.36) and 1.55 (95% CI: 1.38-1.74), respectively. The high-exposure group was at higher risk than the non-exposure group for ED visits for falls or fractures (aHR: 1.31, 95% CI: 1.07-1.60), dizziness (aHR: 1.71, 95% CI: 1.36-2.14), delirium (aHR: 2.05, 95% CI: 1.13-3.73), constipation (aHR: 1.65, 95% CI: 1.35-2.02) and urinary retention (aHR: 1.66, 95% CI: 1.30-2.12). CONCLUSIONS: This study demonstrated that a high anticholinergic burden in older adults increased the risk of all-cause ED visits, anticholinergic ED visits and specific-cause ED visits. SN - 1872-6976 UR - https://www.unboundmedicine.com/medline/citation/31386937/Impact_of_anticholinergic_burden_on_emergency_department_visits_among_older_adults_in_Korea:_A_national_population_cohort_study_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0167-4943(19)30155-4 DB - PRIME DP - Unbound Medicine ER -