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August 26, 2026Basic & Clinical Pharmacology & Toxicology0 citationsOpen Access

The Feasibility and Acceptability of a Collaborative Deprescribing Intervention to Reduce Anticholinergic Burden Among Hospitalised Older Patients

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KIKinda IbrahimEREloise RadcliffeEHEdward Hewertson

Key Points

  • To evaluate the feasibility and acceptability of an electronic screening tool designed to identify anticholinergic medications and facilitate collaborative deprescribing among older hospital inpatients.
  • Conducted a pre-post feasibility study from May to September 2025 among hospitalized patients aged ≥75 years with an Anticholinergic Cognitive Burden (ACB) score ≥3.
  • Used a digital tool to identify target medications and prompt clinical teams to perform medication reviews (discontinue, taper, or switch), assessing recruitment rates, clinical outcomes, intervention costs, and qualitative acceptability.
  • Of 301 screened patients with ACB ≥ 3, 65 (22%) met eligibility criteria, 21 were enrolled (mean age 84.7 years), and 15 completed follow-up, incurring intervention costs of £9.33 per patient.
  • Mean ACB scores decreased from 3.85 at admission to 3.45 at discharge and 3.0 at 1 month (3.44 at 3 months), showing slight variations in delirium and cognition but no differences in depression or quality of life.

Abstract

INTRODUCTION: 37%-48% of older patients receive anticholinergic medicines, increasing the risk for falls, delirium, dementia and death. Hospital admission may provide an opportunity for deprescribing to improve outcomes. This study evaluated the feasibility and acceptability of a digital tool to identify anticholinergic medicines and support deprescribing. METHODS: A pre-post feasibility study was conducted (May-September 2025). Patients aged ≥ 75 with an ACB score of ≥ 3, screened using a digital tool, were recruited. The identified medications were highlighted to the clinical team to prompt a medication review (stop, reduce or switch). Primary outcomes were recruitment and retention. Secondary outcomes included medication and patients' outcomes, healthcare use and acceptability from qualitative interviews. RESULTS: Recruitment was challenging; 65 out of 301 patients with ACB ≥ 3 (22%) were eligible, 21 participated, of which 15 (80%) completed follow-up. Mean age was 84.7 years, and intervention costs were £9.33 per patient. Interviews indicated technical and organisational challenges. Mean ACB scores were 3.85 (admission), 3.45 (discharge), 3.0 (1 month) and 3.44 (3 months), with slight changes in cognition and delirium but no changes in depressive symptoms or quality of life. CONCLUSIONS: Although acceptable, recruitment and technical challenges limited feasibility. Findings should be interpreted cautiously due to the small sample size, and further refinement is needed before implementation.

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Cite This Study

Ibrahim et al. (2026) studied this question.

synapsesocial.com/papers/6a8ebb54451774b83f3b4cefhttps://doi.org/10.1111/bcpt.70277
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