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Prescripción de medicamentos anticolinérgicos en adultos mayores hospitalizados: una revisión sistemática
Rhianna Griffiths1, Steve Lim1,2,3,4, Julian Lin3
1Faculty of Medicine, University of Southampton, Southampton, UK.
Basic & clinical pharmacology & toxicology
|September 1, 2025
Resumen
La prescripción de medicamentos anticolinérgicos en pacientes mayores hospitalizados reduce efectivamente su carga de medicamentos. Se necesita más investigación sobre los resultados clínicos y la seguridad.
Área de la Ciencia:
- Medicina para la edad avanzada
- Farmacia clínica
- Farmacología
Sus antecedentes:
- El uso de medicamentos anticolinérgicos está aumentando en los adultos mayores, aumentando los riesgos de problemas de movilidad y demencia.
- La polifarmacia y las comorbilidades contribuyen a una alta carga anticolinérgica en esta población.
- La hospitalización presenta una ventana crítica para abordar los riesgos de los medicamentos anticolinérgicos.
Objetivo del estudio:
- Evaluar el impacto de la prescripción de medicamentos anticolinérgicos en los resultados en pacientes ancianos ingresados en el hospital.
- Para sintetizar la evidencia sobre las intervenciones destinadas a reducir la carga anticolinérgica en los adultos mayores hospitalizados.
Principales métodos:
- Se realizó una búsqueda sistemática de la literatura en las principales bases de datos (Medline, Web of Science, Cochrane Library, Embase) hasta septiembre de 2024.
- Los estudios incluidos se centraron en intervenciones de desprescripción o revisión de medicamentos en el hospital para la carga anticolinérgica en individuos de 65 años o más.
- Se empleó la síntesis narrativa y la evaluación de la calidad utilizando listas de control de JBI.
Principales resultados:
- Ocho estudios (4 cohortes, 4 cuasi experimentales) cumplieron los criterios, con un seguimiento de hasta 3 meses.
- Las intervenciones depresivas redujeron con éxito las puntuaciones de carga anticolinérgica en seis estudios.
- Tres estudios mostraron una disminución significativa en los pacientes a los que se les recetaron anticolinérgicos, y dos informaron un menor número de medicamentos inadecuados.
Conclusiones:
- Las intervenciones deprescriptivas basadas en el hospital son factibles y efectivas para reducir la carga anticolinérgica.
- Actualmente existen pruebas limitadas con respecto al impacto en los resultados clínicos, los costos y la seguridad.
- Se necesitan ensayos controlados aleatorios adicionales con seguimiento prolongado para comprender plenamente los beneficios y riesgos.
Palabras clave:
carga anticolinérgicaDescripción de la enfermedadcuidados hospitalariosrevisión de la medicaciónadultos mayoresMás Videos Relacionados
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