5PSQ-209 Anticholinergic burden and risk of adverse events in patients from a Spanish nursing home

• Published in: European journal of hospital pharmacy. Science and practice Vol. 28; no. Suppl 1; pp. A157 - A158
• Main Authors: Rodríguez Ramallo, H, Prado Mel, E, Ramos Romero, R, Galván-Borras, MI, Huarte Mendicoa, JC, Fernandez Rubio, B
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group LTD 01-03-2021
• Subjects: Conflicts of interest; Drugs; Nursing homes
• ISSN: 2047-9956; 2047-9964
• DOI: 10.1136/ejhpharm-2021-eahpconf.328

Background and importanceHigh 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 objectivesTo 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 methodsAn 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.Results156 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.Abstract 5PSQ-209 Table 1 Anticholinergic scale Patients with AB Mean AB score Mean anticholinergic risk Anticholinergic cognitive burden scale 62.8% (n=98) 2.1 Medium Anticholinergic risk scale 32.1% (n=50) 1.8 Medium Chew’s list 51.9% (n=81) 2.1 Medium–low Anticholinergic drug scale 55.1% (n=86) 2.4 Medium Anticholinergic activity scale 50.6% (n=79) 2.6 Medium Anticholinergic load scale 54.5% (n=85) 1.8 Medium–low Clinician rated anticholinergic scale 51.3% (n=80) 1.9 Medium Duran’s scale 54.5% (n=85) 1.9 Medium Anticholinergic burden classification 41.0% (n=64) 3.7 High Drug burden index 72.4% (n=113) 1.2 High–medium Conclusion and relevancePatients 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.References and/or acknowledgementsConflict of interestNo conflict of interest