The Evaluation of Relationship Between Polypharmacy and Anticholinergic Burden Scales

Okudur, Saadet Koç; Dokuzlar, Özge; Aydın, Ali Ekrem; Koçyiğit, Süleyman Emre; Soysal, Pınar; Işık, Ahmet Turan

doi:10.14744/nci.2020.17136

Cited by 11 publications

(13 citation statements)

References 35 publications

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“…In polypharmacy, anticholinergic load is associated with dysphagia [ 26 , 27 ], cognitive decline [ 51 ], and poor oral health [ 52 ]. Polypharmacy is a potentially high-risk factor for a high anticholinergic load [ 53 ]. The impact of polypharmacy should be considered when providing rehabilitation for dysphagia and individualized prescription optimization should be provided for correctable polypharmacy.…”

Section: Discussionmentioning

confidence: 99%

Polypharmacy and Its Association with Dysphagia and Malnutrition among Stroke Patients with Sarcopenia

Matsumoto¹,

Yoshimura²,

Nagano³

et al. 2022

Nutrients

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Evidence on polypharmacy in patients with sarcopenia is lacking. We aimed to examine the association of polypharmacy with swallowing function and nutritional risk in post-stroke patient with sarcopenia. This retrospective cohort study included hospitalized patients diagnosed with sarcopenia who needed convalescent rehabilitation following stroke onset. Study outcomes were the Food Intake Level Scale (FILS) as dysphagia assessment and geriatric nutritional risk index (GNRI) as nutritional status at hospital discharge, respectively. To examine the impact of admission polypharmacy, multivariate linear regression analyses were used to determine whether the number of drugs prescribed at hospital admission was associated with these outcomes. As a result, of the 586 patients enrolled, 257 (mean age 79.3 years, 44.0% male) were diagnosed with sarcopenia and were finally analyzed high admission drug prescription numbers were independently associated with FILS (β = −0.133, p = 0.017) and GNRI (β = −0.145, p = 0.003) at hospital discharge, respectively. Polypharmacy is associated with dysphagia and malnutrition in post-stroke patients with sarcopenia. In addition to the combination of nutritional and exercise therapies, review and optimization of prescription medications may be warranted to treat sarcopenia in order to maximize improvement in outcomes for these patients.

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Section: Discussionmentioning

confidence: 99%

Polypharmacy and Its Association with Dysphagia and Malnutrition among Stroke Patients with Sarcopenia

Matsumoto¹,

Yoshimura²,

Nagano³

et al. 2022

Nutrients

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“…The participants were asked to rate the ACB and the other tools against our tool, the IACT. The new AChB calculation system introduced with the IACT, was perceived useful as based on characteristics such as chemical structure, medication side-effects and textual information allowing to score newly added medications in the market, hence differentiating from other tools [ 19 ]. Minor issues highlighted were taken in consideration for amendment.…”

Section: Discussionmentioning

confidence: 99%

“…Lozano-Ortega et al [ 18 ] identified 16 scales, 6 of which were suitable for quantification of anticholinergic exposure. However, the use of these scales and others currently in use [ 19 ] is limited, because they do not use an updating system, and there are differences in which medications are included and the impact of dose.…”

Section: Background and Objectivesmentioning

confidence: 99%

A novel Artificial Intelligence-based tool to assess anticholinergic burden: a survey

et al. 2022

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Background many medications possess anticholinergic activity. Their use is associated with a number of serious adverse effects including cognitive effects. The cumulative anticholinergic effect of medications as assessed by tools such as the anticholinergic burden scale (AchB) can identify people particularly at risk of anticholinergic side-effects. Currently, >20 tools are available for clinicians to use, but there is no consensus on the most appropriate tool. Methods a newly created online tool—International Anticholinergic Cognitive Burden Tool (IACT)—based on natural language processing and chemical structure analysis, was developed and made available for clinicians to test its functions. We carried out a survey (between 8th of February and 31st of March 2021) to assess the overall need for an assessment tool as well as the usability of the IACT. Results a total of 110 responses were received from different countries and practitioners’ groups. The majority of the participants (86.11%) stated they would use a tool for AchB assessment if available and when they were asked to rate the IACT against other tools, amongst 34 responders, 20.59% rated it better and 8.82% rated it significantly better, 44.12% rated it neither better, nor worse, 14.71% rated it worse and 11.76% somewhat worse. Conclusion there is a need for an anticholinergic burden calculator to assess the anticholinergicity of medications. Tools such as the IACT potentially could meet this demand due to its ability to assign scores to current and new medications appearing on the market based both on their chemical structure and reported adverse pharmacological effects.

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“…The anticholinergic burden of the individual medicines was assessed on a score of 0–3, according to their anticholinergic effects. A score of 0 represented no anticholinergic effect, a score of 1 signified possible, and scores of 2 and 3 implied definite anticholinergic effects [ 26 ]. The total anticholinergic burden in each patient was calculated.…”

Section: Methodsmentioning

confidence: 99%

Association between Polypharmacy and Cardiovascular Autonomic Function among Elderly Patients in an Urban Municipality Area of Kolkata, India: A Record-Based Cross-Sectional Study

Samajdar¹,

Das

Sarkar³

et al. 2022

Geriatrics

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We assessed the association between polypharmacy and cardiovascular autonomic function among community-dwelling elderly patients having chronic diseases. Three hundred and twenty-one patients from an urban municipality area of Kolkata, India were studied in August 2022. The anticholinergic burden and cardiac autonomic function (Valsalva ratio, orthostatic hypotension, change in diastolic blood pressure after an isometric exercise, and heart rate variability during expiration and inspiration) were evaluated. Binary logistic regression analysis was performed to find out the association of polypharmacy and total anticholinergic burden with cardiac autonomic neuropathy. A total of 305 patients (age, 68.9 ± 3.4; 65.9% male) were included. Of these patients, 81 (26.6%) were on polypharmacy. Out of these 81 patients, 42 patients were on ninety-eight potential inappropriate medications. The anticholinergic burden and the proportion of patients with cardiac autonomic neuropathy were significantly higher among patients who were on polypharmacy than those who were not (8.1 ± 2.3 vs. 2.3 ± 0.9; p = 0.03 and 56.8% vs. 44.6%; p = 0.01). The presence of polypharmacy and a total anticholinergic burden of > 3 was significantly associated with cardiac autonomic neuropathy (aOR, 2.66; 95% CI, 0.91–3.98 and aOR, 2.51; 95% CI, 0.99–3.52, respectively). Thus, polypharmacy was significantly associated with cardiac autonomic neuropathy among community-dwelling elderly patients.

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The Evaluation of Relationship Between Polypharmacy and Anticholinergic Burden Scales

Cited by 11 publications

References 35 publications

Polypharmacy and Its Association with Dysphagia and Malnutrition among Stroke Patients with Sarcopenia

Polypharmacy and Its Association with Dysphagia and Malnutrition among Stroke Patients with Sarcopenia

A novel Artificial Intelligence-based tool to assess anticholinergic burden: a survey

Association between Polypharmacy and Cardiovascular Autonomic Function among Elderly Patients in an Urban Municipality Area of Kolkata, India: A Record-Based Cross-Sectional Study

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