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Comparative associations between anticholinergic burden and emergency department visits for anticholinergic adverse events in older Korean adults: a nested case-control study using national claims data for validation of a novel country-specific scale.
BMC Pharmacol Toxicol. 2021 Jan 07; 22(1):2.BP

Abstract

BACKGROUND

Considering the limited generalizability of previous anticholinergic burden scales, the Korean Anticholinergic Burden Scale (KABS) as a scale specific to the Korean population was developed. We aimed to validate the KABS by detecting the associations between high anticholinergic burden, measured with the KABS, and emergency department (ED) visits compared to the pre-existing validated scales in older Korean adults.

METHODS

A nested case-control study was conducted using national claims data. The cases included the first anticholinergic ED visits between July 1 and December 31, 2016. Anticholinergic ED visits were defined as ED visits with a primary diagnosis of constipation, delirium, dizziness, fall, fracture, or urinary retention. Propensity score-matched controls were identified. Average daily AB scores during 30 days before the index date were measured. Multivariate logistic regression analyses were performed.

RESULTS

In total, 461,034 were included. The highest proportion of those with high AB was identified with KABS (5.0%). Compared with those who had a KABS score of 0, older adults with a score ≥ 3 were at higher risk for overall anticholinergic ED visits (aOR, 1.62, 95% CI, 1.53-1.72), as well as visits for falls/fractures (aOR: 1.54, 95% CI: 1.40-1.69), dizziness (aOR: 1.44, 95% CI: 1.30-1.59), delirium (aOR: 2.96, 95% CI: 2.28-3.83), constipation (aOR: 1.84, 95% CI: 1.68-2.02), and urinary retention (aOR: 2.13, 95% CI: 1.79-2.55). High AB by KABS showed a stronger association with overall anticholinergic ED visits and visits due to delirium and urinary retention than those by other scales.

CONCLUSIONS

In conclusion, KABS is superior to pre-existing scales in identifying patients with high AB and predicting high AB-related ED visits in older Korean adults.

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 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, Gyeongsan-si, Gyeongsangbuk-do, Republic of Korea.Department of Internal Medicine, Seoul National University Bundang Hospital, Seognam-si, Gyeonggi-do, Republic of Korea.College of Pharmacy and Research Institute of Pharmaceutical Sciences, Seoul National University, Seoul, Republic of Korea. jypharm@snu.ac.kr.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

33413627

Citation

Hwang, Sunghee, et al. "Comparative Associations Between Anticholinergic Burden and Emergency Department Visits for Anticholinergic Adverse Events in Older Korean Adults: a Nested Case-control Study Using National Claims Data for Validation of a Novel Country-specific Scale." BMC Pharmacology & Toxicology, vol. 22, no. 1, 2021, p. 2.
Hwang S, Chung JE, Jun K, et al. Comparative associations between anticholinergic burden and emergency department visits for anticholinergic adverse events in older Korean adults: a nested case-control study using national claims data for validation of a novel country-specific scale. BMC Pharmacol Toxicol. 2021;22(1):2.
Hwang, S., Chung, J. E., Jun, K., Ah, Y. M., Kim, K. I., & Lee, J. Y. (2021). Comparative associations between anticholinergic burden and emergency department visits for anticholinergic adverse events in older Korean adults: a nested case-control study using national claims data for validation of a novel country-specific scale. BMC Pharmacology & Toxicology, 22(1), 2. https://doi.org/10.1186/s40360-020-00467-6
Hwang S, et al. Comparative Associations Between Anticholinergic Burden and Emergency Department Visits for Anticholinergic Adverse Events in Older Korean Adults: a Nested Case-control Study Using National Claims Data for Validation of a Novel Country-specific Scale. BMC Pharmacol Toxicol. 2021 Jan 7;22(1):2. PubMed PMID: 33413627.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comparative associations between anticholinergic burden and emergency department visits for anticholinergic adverse events in older Korean adults: a nested case-control study using national claims data for validation of a novel country-specific scale. AU - Hwang,Sunghee, AU - Chung,Jee Eun, AU - Jun,Kwanghee, AU - Ah,Young-Mi, AU - Kim,Kwang-Il, AU - Lee,Ju-Yeun, Y1 - 2021/01/07/ PY - 2020/08/04/received PY - 2020/12/14/accepted PY - 2021/1/8/entrez PY - 2021/1/9/pubmed PY - 2021/1/9/medline KW - Anticholinergic syndromes KW - Cholinergic antagonists KW - Emergency medical services KW - Geriatrics SP - 2 EP - 2 JF - BMC pharmacology & toxicology JO - BMC Pharmacol Toxicol VL - 22 IS - 1 N2 - BACKGROUND: Considering the limited generalizability of previous anticholinergic burden scales, the Korean Anticholinergic Burden Scale (KABS) as a scale specific to the Korean population was developed. We aimed to validate the KABS by detecting the associations between high anticholinergic burden, measured with the KABS, and emergency department (ED) visits compared to the pre-existing validated scales in older Korean adults. METHODS: A nested case-control study was conducted using national claims data. The cases included the first anticholinergic ED visits between July 1 and December 31, 2016. Anticholinergic ED visits were defined as ED visits with a primary diagnosis of constipation, delirium, dizziness, fall, fracture, or urinary retention. Propensity score-matched controls were identified. Average daily AB scores during 30 days before the index date were measured. Multivariate logistic regression analyses were performed. RESULTS: In total, 461,034 were included. The highest proportion of those with high AB was identified with KABS (5.0%). Compared with those who had a KABS score of 0, older adults with a score ≥ 3 were at higher risk for overall anticholinergic ED visits (aOR, 1.62, 95% CI, 1.53-1.72), as well as visits for falls/fractures (aOR: 1.54, 95% CI: 1.40-1.69), dizziness (aOR: 1.44, 95% CI: 1.30-1.59), delirium (aOR: 2.96, 95% CI: 2.28-3.83), constipation (aOR: 1.84, 95% CI: 1.68-2.02), and urinary retention (aOR: 2.13, 95% CI: 1.79-2.55). High AB by KABS showed a stronger association with overall anticholinergic ED visits and visits due to delirium and urinary retention than those by other scales. CONCLUSIONS: In conclusion, KABS is superior to pre-existing scales in identifying patients with high AB and predicting high AB-related ED visits in older Korean adults. SN - 2050-6511 UR - https://www.unboundmedicine.com/medline/citation/33413627/Comparative_associations_between_anticholinergic_burden_and_emergency_department_visits_for_anticholinergic_adverse_events_in_older_Korean_adults:_a_nested_case_control_study_using_national_claims_data_for_validation_of_a_novel_country_specific_scale_ L2 - https://bmcpharmacoltoxicol.biomedcentral.com/articles/10.1186/s40360-020-00467-6 DB - PRIME DP - Unbound Medicine ER -
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