Key result
In an Australian primary care population aged ≥65 years, 8% of patients had a Fox anticholinergic burden score ≥4, which increased to 33% when using the modified Fox-plus scale.
Cross-Sectional (n=4,853)
Yes
A significant proportion of elderly primary care patients in Australia have a high anticholinergic burden, highlighting the need for medication review to minimize the risk of cognitive impairment.
Scale choice markedly alters high anticholinergic burden estimates in older Australians; leaves open optimal tool for cognitive risk prediction.
Aim To determine the anticholinergic burden (ACB) of an Australian primary care population. Method A cross‐sectional study was undertaken of medication data from 11 general practices. Participants were active patients aged 65 years and over seen at least 3 times in the last 2 years (n = 4853). The ACB score was calculated based on a UK peer‐reviewed scoring system (Fox) and a modified scale (Fox‐plus) that included medications not present in the Fox scale. The main outcome measure was total ACB from prescribed medications. Results A Fox ACB score ≥ 4 is associated with increased risk of morbidity and mortality, 249 (9%) females, 130 (6%) males and 379 (8%) overall fell in this category. Applying the Fox‐plus ACB scale, 983 (36%) females, 630 (30%) males and 1613 (33%) overall fell in this category. Conclusion A large proportion of the elderly population may have cognitive impairment because of their therapy. Alternative medications or strategies are needed to maintain therapeutic benefits with a low ACB.
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Ball et al. (2013) conducted a cross-sectional in Anticholinergic burden (n=4,853). Anticholinergic burden assessment was evaluated on Total ACB from prescribed medications. In an Australian primary care population aged ≥65 years, 8% of patients had a Fox anticholinergic burden score ≥4, which increased to 33% when using the modified Fox-plus scale.
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