Journal of the American Geriatrics Society

Volume 63, Issue 1 p. 85-90

Clinical Investigations

Comparison of Anticholinergic Risk Scales and Associations with Adverse Health Outcomes in Older People

Mohammed Saji Salahudeen PharmD,

Mohammed Saji Salahudeen PharmD

School of Pharmacy, University of Otago, Dunedin, New Zealand

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Sarah N. Hilmer MBBS, PhD,

Sarah N. Hilmer MBBS, PhD

Sydney Medical School, Royal North Shore Hospital, University of Sydney, Sydney, New South Wales, Australia

Kolling Institute of Medical Research, University of Sydney, Sydney, New South Wales, Australia

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Prasad S. Nishtala M Pharm, PhD,

Corresponding Author

Prasad S. Nishtala M Pharm, PhD

School of Pharmacy, University of Otago, Dunedin, New Zealand

Address correspondence to Dr. Prasad S. Nishtala, School of Pharmacy, University of Otago, PO Box 56, Dunedin 9054, New Zealand. E-mail: [email protected]Search for more papers by this author

Mohammed Saji Salahudeen PharmD,

Mohammed Saji Salahudeen PharmD

School of Pharmacy, University of Otago, Dunedin, New Zealand

Search for more papers by this author

Sarah N. Hilmer MBBS, PhD,

Sarah N. Hilmer MBBS, PhD

Sydney Medical School, Royal North Shore Hospital, University of Sydney, Sydney, New South Wales, Australia

Kolling Institute of Medical Research, University of Sydney, Sydney, New South Wales, Australia

Search for more papers by this author

Prasad S. Nishtala M Pharm, PhD,

Corresponding Author

Prasad S. Nishtala M Pharm, PhD

School of Pharmacy, University of Otago, Dunedin, New Zealand

Address correspondence to Dr. Prasad S. Nishtala, School of Pharmacy, University of Otago, PO Box 56, Dunedin 9054, New Zealand. E-mail: [email protected]Search for more papers by this author

First published: 17 January 2015

https://doi.org/10.1111/jgs.13206

Citations: 118

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Abstract

Objectives

To investigate whether anticholinergic burden scores from nine published anticholinergic scales are associated with adverse health outcomes, including hospital admissions, hospitalizations for falls, hospital length of stay (LOS), and more visits to general practitioners (GPs).

Design

Pharmacoepidemiological population-based study.

Setting

New Zealand.

Participants

Population aged 65 and older (n = 537,387).

Measurements

Data were analyzed for 537,387 individuals from the Pharmaceutical Claims Data Mart data set (2011). Anticholinergic medication exposure was calculated using nine published scales. Events information (2012) was extracted from the National Minimum Datasets using International Classification of Diseases, Tenth Revision, codes. Predictors of hospital admissions, hospitalizations for falls, LOS, and GP visits were examined using regression models adjusting for age, sex, ethnicity, comorbidities, and polypharmacy.

Results

Prevalence of exposure to anticholinergic medicines ranged from 22.8% to 55.9% according to the different scales. Multivariate regression analysis showed that anticholinergic burden scores quantified according to all nine scales were significantly associated with hospital admissions, hospitalizations for falls, LOS, and GP visits (P < .001). The strongest predictors of these outcomes were the Drug Burden Index—Anticholinergic component scores, aged 85 and older, female sex, and polypharmacy.

Conclusion

There are substantial differences in the estimation of anticholinergic burden exposure between the nine scales. Anticholinergic burden scores obtained from each of the scales were associated with adverse clinical outcomes of interest.

Supporting Information

References

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Citing Literature

Volume63, Issue1

January 2015

Pages 85-90

Comparison of Anticholinergic Risk Scales and Associations with Adverse Health Outcomes in Older People

Abstract

Objectives

Design

Setting

Participants

Measurements

Results

Conclusion

Supporting Information

References

Citing Literature

References

Information

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Comparison of Anticholinergic Risk Scales and Associations with Adverse Health Outcomes in Older People

Abstract

Objectives

Design

Setting

Participants

Measurements

Results

Conclusion

Supporting Information

References

Citing Literature

References

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