1. Interventions for reducing anticholinergic medication burden in older adults—a systematic review and meta-analysis.
- Author
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Braithwaite, Eve, Todd, Oliver M, Atkin, Abigail, Hulatt, Rachel, Tadrous, Ragy, Alldred, David P, Pirmohamed, Munir, Walker, Lauren, Lawton, Rebecca, and Clegg, Andrew
- Subjects
CINAHL database ,MEDICAL databases ,PSYCHOLOGY information storage & retrieval systems ,COGNITION disorders ,PUBLICATION bias ,PARASYMPATHOMIMETIC agents ,META-analysis ,MEDICAL information storage & retrieval systems ,CONFIDENCE intervals ,SYSTEMATIC reviews ,MEDICATION error prevention ,DEPRESCRIBING ,INAPPROPRIATE prescribing (Medicine) ,QUALITY of life ,ACCIDENTAL falls ,QUALITY assurance ,DESCRIPTIVE statistics ,RESEARCH funding ,MEDLINE ,PATIENT care ,ODDS ratio ,OLD age - Abstract
Introduction Anticholinergic medications block the neurotransmitter acetylcholine in the brain and peripheral nervous system. Many medications have anticholinergic properties, and the cumulative effect of these medications is termed anticholinergic burden. Increased anticholinergic burden can have short-term side effects such as dry mouth, blurred vision and urinary retention as well as long-term effects including dementia, worsening physical function and falls. Methods We carried out a systematic review (SR) with meta-analysis (MA) looking at randomised controlled trials addressing interventions to reduce anticholinergic burden in older adults. Results We identified seven papers suitable for inclusion in our SR and MA. Interventions included multi-disciplinary involvement in medication reviews and deprescribing of AC medications. Pooled data revealed no significant difference in outcomes between control and intervention group for falls (OR = 0.76, 95% CI: 0.52–1.11, n = 647), cognition (mean difference = 1.54, 95% CI: −0.04 to 3.13, n = 405), anticholinergic burden (mean difference = 0.04, 95% CI: −0.11 to 0.18, n = 710) or quality of life (mean difference = 0.04, 95% CI: −0.04 to 0.12, n = 461). Discussion Overall, there was no significant difference with interventions to reduce anticholinergic burden. As we did not see a significant change in anticholinergic burden scores following interventions, it is likely other outcomes would not change. Short follow-up time and lack of training and support surrounding successful deprescribing may have contributed. [ABSTRACT FROM AUTHOR]
- Published
- 2023
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