Abstract
Background: in older people, medications with anticholinergic (antimuscarinic) effects are associated with adverse clinical outcomes, the risk increasing with increasing anticholinergic exposure. Many anticholinergics are recognised as potentially inappropriate and efforts to reduce prescription have been ongoing. We examined temporal trends of anticholinergic prescription and exposure in older people.
Methods: anonymised data on all prescribed medication dispensed to people ≥65 years in Tayside, Scotland were obtained for the years 1995 (n = 67,608) and 2010 (n = 73,465). The Anticholinergic Risk Scale (ARS) was adapted (mARS) to include newer medications and medications identified in other scales as having moderate to strong anticholinergic activity. An individual's mARS score was the sum of scores for individual medications. Differences in prescription of anticholinergic medications and mARS scores between 1995 and 2010 were examined.
Results: a significantly higher proportion of older people received any anticholinergic medication in 2010 compared with 1995 (23.7 versus 20.7%; P <0.001). High anticholinergic exposure (mARS scores ≥3) was seen in 7.3% in 1995 and 9.9% in 2010 (P
< 0.001). Prescription of individual anticholinergic medication was
small—only three medications were prescribed to >2% of
people. The risk of high anticholinergic exposure
increased in those with polypharmacy, social deprivation, those living
in
care homes and women. Conclusion: despite
increasing evidence of adverse outcomes, the proportion of older people
prescribed anticholinergic medications and
the proportion with a high anticholinergic exposure
has increased between 1995 and 2010. Prescription of individual drug is
small so cumulative anticholinergic scores may help
future efforts to reduce anticholinergic prescription in older people.
Original language | English |
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Pages (from-to) | 515-521 |
Number of pages | 7 |
Journal | Age and Ageing |
Volume | 43 |
Issue number | 4 |
Early online date | 10 Dec 2013 |
DOIs | |
Publication status | Published - Jul 2014 |
Keywords
- anticholinergic medication
- Older people
- PRESCRIPTION