Background and importance High anticholinergic burden (AB) has been associated with central and peripheral adverse events. Several anticholinergic scales were developed to estimate this AB. Patients residing in nursing homes are frequently prescribed a wide range of drugs but the rates of anticholinergic drug usage and the AB associated with these drugs have not been previously described.
Aim and objectives To study the anticholinergic prescription rates of patients residing in a nursing home and to compare the results from 10 different anticholinergic scales when estimating AB.
Material and methods An observational cross sectional study was carried out from June 2020 to September 2020 in a nursing home. Variables collected were: age, sex, number of drugs prescribed, number of anticholinergic drugs prescribed, anticholinergic drugs prescribed, AB and anticholinergic risk. Patients were classified as polymedicated if more than 5 drugs were prescribed and heavy polymedicated if more than 10 drugs were prescribed. AB and anticholinergic risk were estimated with 10 anticholinergic scales.
Results 156 patients, 59.3% men, median age 74.2 (IQR 67.4–82.8) years, were prescribed a median of 10 (range 0–26) drugs with 2 (0–6) of them with anticholinergic activity. 84.0% (n=131) of patients were polymedicated and 50.6% (n=79) were heavily polymedicated. The most frequently prescribed anticholinergic drugs were: furosemide (21.2%, n=33), tramadol (13.5%, n=21), lorazepam (14.7%, n=23), metformin (13.5%, n=21) and clorazepate (12.8%, n=20). Anticholinergic risk and anticholinergic drug burden of patients who were prescribed at least one anticholinergic drug are shown in table 1.
Conclusion and relevance Patients included were heavily polymedicated, often with drugs with anticholinergic activity.
Most anticholinergic scales estimated at least a medium anticholinergic risk, predicting a relatively high risk for anticholinergic adverse events. This work highlights the differences in anticholinergic scales when estimating the anticholinergic risk and its capacity to recognise this risk in the studied population.
Conflict of interest No conflict of interest
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