Key result
High anticholinergic burden was present in 38.3% of admitted geriatric patients and was associated with significantly higher drug use and higher risk of 30-day readmission.
Why the study?
High anticholinergic burden is linked to higher risk of hospitalisation, readmission, and mortality in geriatric patients, prompting the need to update an anticholinergic burden scale for drugs registered in Denmark and evaluate patient burden.
What is the anticholinergic burden at admission and discharge among hospitalised geriatric patients, and how does it affect clinical outcomes?
Observational (n=196)
No
What is the anticholinergic burden at admission and discharge among hospitalised geriatric patients, and how does it affect clinical outcomes?
A high anticholinergic burden is prevalent among admitted geriatric patients and is associated with an increased risk of 30-day readmission, highlighting the need for medication review.
Updated Danish scale may refine local geriatric prescribing review; leaves open whether burden reduction improves clinical outcomes.
BACKGROUND: High anticholinergic burden is associated with an increased risk of hospitalisation, readmission, and mortality in geriatric patients. The objectives were to develop an updated anticholinergic burden scale for drugs registered in Denmark and to estimate the burden at admission and discharge for hospitalised patients at the Geriatric Ward of Sønderjylland Hospital. METHODS: The updated scale was developed through a systematic evaluation of the anticholinergic effect for all active pharmaceutical ingredients (APIs) listed on validated burden scales. APIs registered in 2020 and 2021 were evaluated separately for possible anticholinergic effect. The anticholinergic effect of each API was scored from 1 (low) to 3 (high). The scale was applied to medical records for patients hospitalised between October 2021 and March 2022. RESULTS: The scale comprised 87 APIs with anticholinergic effect. We applied the scale on 196 patients aged (median [IQR]) 84 (78-89) years. Of these patients, 75 (38.3%) had a high burden (≥3) on admission. These patients had significantly higher drug use and higher risk of 30-day readmission but no relationship with length of stay. Overall, the anticholinergic burden was unchanged at discharge for 109 (55.1%) patients. CONCLUSION: An updated scale for estimation of the anticholinergic burden in geriatric patients was successfully developed, and a high burden among the admitted geriatric patients was found.
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Kehman et al. (2024) conducted an observational in Hospitalized geriatric patients (n=196). High anticholinergic burden vs. Lower anticholinergic burden was evaluated on Anticholinergic burden at admission and discharge, and 30-day readmission. High anticholinergic burden was present in 38.3% of admitted geriatric patients and was associated with significantly higher drug use and higher risk of 30-day readmission.
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