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An anticholinergic burden score for German prescribers: score development
Esther Katharina Kiesel1, Yvonne Marina Hopf2, Michael Drey3
1Department of Pharmacy, University Hospital, LMU Munich, Munich, Germany. esther.kiesel@med.uni-muenchen.de.
BMC Geriatrics
|October 12, 2018
Summary
This study developed an anticholinergic burden score for German drugs to help clinicians reduce harmful medications for elderly patients. The score categorizes drug effects, aiding in safer prescribing practices.
Area of Science:
- Geriatric Pharmacology
- Medication Safety
- Clinical Pharmacy
Background:
- Anticholinergic drugs increase risks of falls, cognitive decline, and delirium in elderly patients.
- Prescribers often lack awareness of the cumulative anticholinergic burden (ACB) in their patients.
- Peripheral side effects include dry mouth and constipation.
Purpose of the Study:
- To develop an anticholinergic burden score for drugs licensed in Germany.
- To create a tool for clinicians at the prescribing level.
- To aid in reducing inappropriate medication use in the elderly.
Main Methods:
- Systematic literature search of PubMed for existing ACB tools.
- Extraction and reduction of quantitative grading scores for German-available drugs.
- Expert reevaluation and scoring of drugs based on anticholinergic effect (none, weak, moderate, strong).
Main Results:
- A total of 504 drugs were scored for their anticholinergic effects.
- 356 drugs had no anticholinergic effect.
- 104 drugs were weak, 18 moderate, and 29 had strong anticholinergic effects.
Conclusions:
- A new ACB score for German-authorized drugs is available for clinical practice.
- This score can help reduce potentially inappropriate medications in elderly patients.
- Further clinical studies are needed to validate its impact on reducing anticholinergic side effects.
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