Impact of Anticholinergic Drugs Should Be Considered in Older Patients
HealthDay News — Anticholinergic medications are frequently prescribed to older adults, but their negative impact should be considered, according to a review published online December 23 in the Journal of Pharmacy Practice and Research.
Noting that anticholinergic medications are often used by older adults to manage a wide range of chronic conditions, Lisa Kouladjian O'Donnell, M.Pharm, PhD, from the University of Sydney, and colleagues reviewed the literature published regarding anticholinergic prescribing among older adults.
Anticholinergic medications can have a negative impact in older adults, including central nervous system adverse effects, such as cognitive impairment, confusion, delirium, and falls, as well as peripheral adverse effects such as constipation, dry eyes, and urinary retention. The researchers note that in order to quantify anticholinergic burden, several measures have been developed and validated, including the Anticholinergic Drug Scale, Anticholinergic Risk Scale, and Anticholinergic Cognitive Burden scale. Limited evidence is available for translation of these measures into clinical practice. Interventions, including pharmacist review and integration of anticholinergic burden measures, demonstrate reduction in anticholinergic prescribing. Careful cessation or tapering is involved in deprescribing anticholinergic medication, with consideration of the specific clinical scenario and the pharmacology of the medications.
"Future deprescribing trials may provide further guidance on the implementation of interventions and outcomes of deprescribing anticholinergic medications in clinical practice," the authors write.