The use of medications with anticholinergic properties and risk factors for their use in hospitalised elderly patients

ABSTRACT Purpose The aims of the present study were to evaluate the use of drugs with anticholinergic properties in elderly patients and to identify risk factors that increase the patient's chance of being given such medications. Methods The study was performed on a sample of 1636 patients aged...

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Published in:	Pharmacoepidemiology and drug safety Vol. 21; no. 2; pp. 170 - 176
Main Authors:	Wawruch, Martin, Macugova, Agata, Kostkova, Lenka, Luha, Jan, Dukat, Andrej, Murin, Jan, Drobna, Veronika, Wilton, Lynda, Kuzelova, Magdalena
Format:	Journal Article
Language:	English
Published:	Chichester, UK John Wiley & Sons, Ltd 01-02-2012 Wiley Subscription Services, Inc
Subjects:	Aged anticholinergic burden Cholinergic Antagonists - adverse effects Cholinergic Antagonists - therapeutic use comorbidities depression Female Health risk assessment Hospitalization - statistics & numerical data Humans Logistic Models Male Older people Patient Admission - statistics & numerical data Patient Discharge - statistics & numerical data polypharmacy Practice Patterns, Physicians' - statistics & numerical data Retrospective Studies Risk Factors
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Summary:	ABSTRACT Purpose The aims of the present study were to evaluate the use of drugs with anticholinergic properties in elderly patients and to identify risk factors that increase the patient's chance of being given such medications. Methods The study was performed on a sample of 1636 patients aged ≥65 years hospitalised during the period between 1 January 2008 and 31 December 2009 in three municipal hospitals. To evaluate the factors influencing the use of anticholinergic medications, we compared two groups—users and non‐users of such drugs—in terms of sociodemographic and clinical characteristics as well as comorbid conditions. The most important risk factors were identified using the binary logistic regression model. Results Hospitalisation led to a significant increase in the prevalence of anticholinergic medication users, when comparing their occurrence at the time of hospital admission and discharge (10.5% and 14.2%, respectively; p < 0.001). A significantly higher total number of prescribed drugs were found in the group of users compared with non‐users, at both hospital admission (7.2 ± 3.5 vs 5.7 ± 3.1; p < 0.001) and discharge (8.7 ± 3.1 vs 7.5 ± 2.9; p < 0.001). Immobilisation, urinary incontinence and retention, constipation, gastroduodenal ulcer disease as well as neurologic and psychiatric comorbidities (depression, Parkinson's disease, epilepsy) appeared as the most important risk factors of using anticholinergic medications. Conclusions Physicians should be aware of the greater risk of adverse anticholinergic effects of drugs in certain therapeutic classes in the elderly. In patients with risk factors mentioned previously, special attention should be paid to active identification of anticholinergic effects of medications. Copyright © 2011 John Wiley & Sons, Ltd.
Bibliography:	ark:/67375/WNG-SFN2NWS4-L ArticleID:PDS2169 VEGA - No. 1/0135/09 European Reconstruction and Development Fund istex:983C641AA02D7051EC65918F1EBC849301885489 Centre of Excellence for Strokes at the Faculty of Medicine, Comenius University - No. 26240120024 ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	1053-8569 1099-1557
DOI:	10.1002/pds.2169