Dementia patients have greater anti-cholinergic drug burden on discharge from hospital: A multicentre cross-sectional study
Year: 2021
Type: article
Study design: Observational Study
Abstract: Introduction Anticholinergic medications block cholinergic transmission. The central effects of anticholinergic drugs can be particularly marked in patients with dementia. Furthermore, anticholinergics antagonise the effects of cholinesterase inhibitors, the main dementia treatment. Objectives This study aimed to assess anticholinergic drug prescribing among dementia patients before and after admission to UK acute hospitals. Methods 352 patients with dementia were included from 17 hospitals in the UK. All were admitted to surgical, medical or Care of the Elderly wards in 2019. Information about patients’ prescriptions were recorded on a standardised form. An evidence-based online calculator was used to calculate the anticholinergic drug burden of each patient. The correlation between two subgroups upon admission and discharge was tested with Spearman’s Rank Correlation. Results Table 1 shows patient demographics. On admission, 37.8% of patients had an anticholinergic burden score ≥1 and 5.68% ≥3. At discharge, 43.2% of patients had an anticholinergic burden score ≥1 and 9.1% ≥3. The increase was statistically significant (rho 0.688; p=2.2x10 -16 ). The most common group of anticholinergic medications prescribed at discharge were psychotropics (see Figure 1). Among patients prescribed cholinesterase inhibitors, 44.9% were also taking anticholinergic medications. Conclusions This multicentre cross-sectional study found that people with dementia are frequently prescribed anticholinergic drugs, even if also taking cholinesterase inhibitors, and are significantly more likely to be discharged with a higher anticholinergic drug burden than on admission to hospital. Conflict of interest This project was planned and executed by the authors on behalf of SPARC (Student Psychiatry Audit and Research Collaborative). We thank the National Student Association of Medical Research for allowing us use of the Enketo platform. Judith Harrison was su
Source: European Psychiatry
Authors: J. Randall, A. Hook, C-M. Grubb, N. Ellis, J. Wellington, A. Hemmad, A. Zerdelis, B. Geers, B. Sykes, C. Auty, C. Vinchenzo, C. Thorburn, D. Asogbon, E. Granger, H. Boagey, J. Raphael, K. Patel, K. Bhargava, M.-K. Dolley, M. Maden, M. Shah, Q. Lee, R. Vaidya, S. Sehdev, S. Barai, S. Roche, U. Khalid, J. Harrison, D. Codling
Institutions: Cardiff University, Newcastle University, James Cook University Hospital, University of Manchester, University of Exeter, Lancaster University, University of Bristol, University of Birmingham, University Hospitals of Morecambe Bay NHS Foundation Trust, University of Oxford, University of East Anglia, Queen Mary University of London, University of Cambridge, University College London, King's College London
Language: English
Subfield: Geriatrics and Gerontology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,575
OpenAlex ID: W3196012158