Reducing Anticholinergic Burden in Hospitalised Older Adults: Analysis From the INFAR Study

This study aimed to evaluate the effectiveness of pharmacist-led medication reviews in reducing the anticholinergic burden of hospitalised patients with cardiovascular diseases (CVDs), to identify which anticholinergic medications were most frequently prescribed or discontinued during hospitalisation and to investigate factors associated with an elevated anticholinergic burden via secondary analysis of the INFAR study. An uncontrolled before-and-after design was used, and medication reviews were performed for all patients so that the anticholinergic burden of medications prescribed to older adults during their hospital stay could be examined. The mean age of the 319 patients was 68.9 years (±6.2), and upon hospital admission, 40.4% were classified as having a high anticholinergic burden, decreasing to 22.6% at discharge. Multivariate analysis at admission indicated that polypharmacy (PR = 2.00; 95% CI = 1.47-2.72) and potentially inappropriate medication (PR = 4.47; 95% CI = 2.10-9.53) were independently associated with a higher anticholinergic burden; however, only inappropriate medication was significantly associated with a high burden (PR = 2.39; 95% CI = 1.54-3.71) at discharge. The results indicate that a clinical pharmacist-led medication review may reduce the anticholinergic burden in older adults with CVD, highlighting the importance of such a review in promoting safer prescribing practices during hospitalisation.