Background Anticholinergic drugs may increase the risk of cognitive and functional disorders in older patients. Anticholinergic exposure quantified by anticholinergic scales (AS) can detect patients with a high risk of adverse events.
Purpose Design, development and validation of a tool that calculates the anticholinergic burden.
Material and methods A tool was designed which calculates the anticholinergic burden based on different AS described in a systematic review. The main aim of the review was to identify all AS described in the literature and to evaluate them in polypathological patients (PP), a subpopulation of patients with chronic diseases and increasing frailty, or with similar characteristics. For its development, a database was created with all drugs included in the scales and specific scores given to each. In the case of DBI, the effective minimum dose of each drug adapted from the National Drug Formulary Spain was added. Once the software was created, it was validated for accuracy. Medication data were collected from PP, included in the IMPACTO project. The anticholinergic burden was calculated twice: manually and with the web calculator.
Results The tool was named Anticholinergic Burden Calculator (http://www.anticholinergicscales.es/). It generates reports on 10 AS, elaborated to older patients in general according to the review. The report offers final anticholinergic risk scores in three groups: low, medium and high, according to the risk categorisation made by the authors or developers of each scale. It also describes the score of each drug by scale. Subsequently, it analysed medication from 35 patients and a total of 310 drugs. It calculated anticholinergic burden based on 10 AS. The results showed 100% agreement between both manual and automated calculations from the software.
Conclusion The tool facilitates calculation of the total load using 10 scales in a single step. Moreover, doctors and pharmacists obtained very valuable information on treatment. They can identify which patients are at risk and can easily and quickly focus on them when reviewing medicines taken by elderly patients.
References and/or acknowledgements Villalba-Moreno AM, Alfaro-Lara ER, Pérez-Guerrero MC, et al. Systematic review on the use of anticholinergic scales in polypathological patients. Arch Gerontol Geriatr2016;62:1–8.
No conflict of interest
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