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Consistency between anticholinergic burden scales in the elderly with fractures.
PLoS One. 2020; 15(2):e0228532.Plos

Abstract

OBJECTIVE

Falls and bone fractures are important causes of morbidity and mortality in the elderly. The objective of this study was to identify the degree of consistency between the anticholinergic scales used for patients diagnosed with fractures.

METHODS

This was an analytical agreement study conducted in patients diagnosed with vertebral and nonvertebral fractures in Colombia. The quadratic-weighted kappa coefficient was used to identify the consistency between the Anticholinergic Drug Scale-ADS, Anticholinergic Cognitive Burden Scale-ACB and Anticholinergic Risk Scale-ARS in assessing the prescriptions of fracture patients during the month prior to the fracture, during their stay as an inpatient and at discharge, according to Landis criteria.

RESULTS

220 patients with fractures were included, with a mean age of 75.3±10.3 years, and 68.2% were women. The ACB scale identified the highest anticholinergic burden (26.8%) in prescriptions made the month before the fracture, and the highest agreement was between ACB and ADS (0.717); during hospitalization and at discharge, the cholinergic antagonists were best identified with ADS (77.7% and 72.1%, respectively), with the best agreement between ACB and ARS (0.613 and 0.568, respectively). The prescription of tramadol was found in 64.1% of hospitalized patients and in 61.4% of patients at the time of discharge.

CONCLUSIONS

The scales evaluated show marked discrepancies between them, with highly variable frequencies of anticholinergic drugs identified at the different prescription times, and with low agreement among them, which is why the scales are not interchangeable in patients with bone fractures.

Authors+Show Affiliations

Grupo de Investigación en Farmacoepidemiología y Farmacovigilancia, Universidad Tecnológica de Pereira-Audifarma S.A, Pereira, Risaralda, Colombia. Grupo Biomedicina, Fundación Universitaria Autónoma de las Américas, Pereira, Risaralda, Colombia.Universidad de Cartagena, Cartagena, Bolivar, Colombia.Internal Medicine, Geriatrics, Grupo de Investigación en Farmacoepidemiología y Farmacovigilancia, Hospital Universitario de Caldas, Manizales, Colombia.Grupo de Investigación en Farmacoepidemiología y Farmacovigilancia, Universidad Tecnológica de Pereira-Audifarma S.A, Pereira, Risaralda, Colombia.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32092055

Citation

Valladales-Restrepo, Luis Fernando, et al. "Consistency Between Anticholinergic Burden Scales in the Elderly With Fractures." PloS One, vol. 15, no. 2, 2020, pp. e0228532.
Valladales-Restrepo LF, Duran-Lengua M, Castro-Osorio EE, et al. Consistency between anticholinergic burden scales in the elderly with fractures. PLoS One. 2020;15(2):e0228532.
Valladales-Restrepo, L. F., Duran-Lengua, M., Castro-Osorio, E. E., & Machado-Alba, J. E. (2020). Consistency between anticholinergic burden scales in the elderly with fractures. PloS One, 15(2), e0228532. https://doi.org/10.1371/journal.pone.0228532
Valladales-Restrepo LF, et al. Consistency Between Anticholinergic Burden Scales in the Elderly With Fractures. PLoS One. 2020;15(2):e0228532. PubMed PMID: 32092055.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Consistency between anticholinergic burden scales in the elderly with fractures. AU - Valladales-Restrepo,Luis Fernando, AU - Duran-Lengua,Marlene, AU - Castro-Osorio,Edgar Eduardo, AU - Machado-Alba,Jorge Enrique, Y1 - 2020/02/24/ PY - 2019/05/15/received PY - 2019/12/30/accepted PY - 2020/2/25/entrez PY - 2020/2/25/pubmed PY - 2020/5/7/medline SP - e0228532 EP - e0228532 JF - PloS one JO - PLoS One VL - 15 IS - 2 N2 - OBJECTIVE: Falls and bone fractures are important causes of morbidity and mortality in the elderly. The objective of this study was to identify the degree of consistency between the anticholinergic scales used for patients diagnosed with fractures. METHODS: This was an analytical agreement study conducted in patients diagnosed with vertebral and nonvertebral fractures in Colombia. The quadratic-weighted kappa coefficient was used to identify the consistency between the Anticholinergic Drug Scale-ADS, Anticholinergic Cognitive Burden Scale-ACB and Anticholinergic Risk Scale-ARS in assessing the prescriptions of fracture patients during the month prior to the fracture, during their stay as an inpatient and at discharge, according to Landis criteria. RESULTS: 220 patients with fractures were included, with a mean age of 75.3±10.3 years, and 68.2% were women. The ACB scale identified the highest anticholinergic burden (26.8%) in prescriptions made the month before the fracture, and the highest agreement was between ACB and ADS (0.717); during hospitalization and at discharge, the cholinergic antagonists were best identified with ADS (77.7% and 72.1%, respectively), with the best agreement between ACB and ARS (0.613 and 0.568, respectively). The prescription of tramadol was found in 64.1% of hospitalized patients and in 61.4% of patients at the time of discharge. CONCLUSIONS: The scales evaluated show marked discrepancies between them, with highly variable frequencies of anticholinergic drugs identified at the different prescription times, and with low agreement among them, which is why the scales are not interchangeable in patients with bone fractures. SN - 1932-6203 UR - https://www.unboundmedicine.com/medline/citation/32092055/Consistency_between_anticholinergic_burden_scales_in_the_elderly_with_fractures_ L2 - https://dx.plos.org/10.1371/journal.pone.0228532 DB - PRIME DP - Unbound Medicine ER -