Anticholinergic burden in older women: not seeing the wood for the trees

Parkinson, L. et al. (2015) Anticholinergic burden in older women: not seeing the wood for the trees. Medical Journal of Australia, 202(2), pp. 91-4. (PMID:25627741)

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Abstract

OBJECTIVES To identify medicines contributing to and describe predictors of anticholinergic burden among community-dwelling older Australian women. DESIGN, SETTING AND PARTICIPANTS Retrospective longitudinal analysis of data from the Australian Longitudinal Study on Women's Health linked to Pharmaceutical Benefits Scheme medicines data from 1 January 2008 to 30 December 2010; for 3694 women born in 1921-1926. MAIN OUTCOME MEASURES Anticholinergic burden calculated from Anticholinergic Drug Scale (ADS) scores derived from ADS levels (0 to 3) for all medicines used by each woman, summed over each 6-month period (semester), medicines commonly used by women with high semester ADS scores (defined as 75th percentile of scores). RESULTS 1126 women (59.9%) used at least one medicine with anticholinergic properties. The median ADS score was 4 or 5 across all semesters. Most anticholinergic medicines used by women who had a high anticholinergic burden (ADS score, ≥ 9) had a low anticholinergic potency (ADS level 1). Increasing age, cardiovascular disease, and number of other medicines used were predictive of a higher anticholinergic burden. CONCLUSIONS A high anticholinergic medicines burden in this group was driven by the use of multiple medicines with lower anticholinergic potency rather than the use of medicines with higher potency. This is a novel and important finding for clinical practice as doctors would readily identify the risk of a high anticholinergic burden for patients using high potency medicines, but may be less likely to identify this risk for users of multiple medicines with low anticholinergic potency.

Item Type:Articles (Other)
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Mccowan, Professor Colin
Authors: Parkinson, L., Magin, P. J., Thomson, A., Byles, J. E., Caughey, G. E., Etherton-Beer, C., Gnjidic, D., Hilmer, S. N., Lo, T. K. T., McCowan, C., Moorin, R., and Pond, C. D.
Subjects:R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
R Medicine > RM Therapeutics. Pharmacology
College/School:College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > Robertson Centre
Journal Name:Medical Journal of Australia
Publisher:Australasian Medical Publishing Company
ISSN:0025-729X
ISSN (Online):1326-5377

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