OBJECTIVES

: To analyse the anticholinergic risk (AR) in elderly nursing home patients.

Anticholinergic drugs in elderly people have been associated with some serious side-effects, ranging from dry mouth, constipation, and visual impairments to confusion, delirium, and severe cognitive decline. The toxicity is often the result of the cumulative anticholinergic burden of multiple prescription medications and metabolites rather than of a single compound.

METHODS

: A cross-sectional study including all elderly patients residing in a nursing home in May 2018. Age, sex and pharmacotherapy were collected for each patient. AR was calculated using an Anticholinergic Burden web tool Calculator which includes 10 different Anticholinergic scales described in a systematic review.

The scales offer final AR scores classified in three groups: low, medium and high, according to the risk categorisation made by the authors of each scale. Higher scores are associated with increased AR.

RESULTS

: We analysed 111 patients; mean age:73.93±8.35 years, 79.28% males. Mean prescribed drugs: 7.39±3.94.

There were 16 patients (14.41%) without risk; 35 (31.53%) with medium risk and 35 (31.53%) with high risk. Twenty-five patients (22.52%) did not receive any anticholinergic drug.According to AR score, 70 patients (58.3%) were taking at least one anticholinergic drug, 39 drugs were involved.We identified 39 drugs with anticholinergic potency being the most common: alprazolam (43.6%), mirtazapine (25.6%), lorazepam (23.1%), sertraline (20.5%).

Regarding ATC code, drugs from “N05 psycholeptics” group were mainly involved (30.63%); followed by “N06. Psychoanaleptics” (10.81%)and “A10. Drugs used in diabetes”(9.9%).

CONCLUSIONS

: A high proportion of elderly patients are at risk of anticholinergics adverse events because of their prescribed treatment. In consequence, detection of AR can be an important strategy for optimising treatment in these patients, particularly in those suffering from dementia. Pharmaceutical care in elderly nursing home enables the optimisation of pharmacotherapy, improving patient safety.

REFERENCES AND/OR ACKNOWLEDGEMENTS

All staff of Geriatric-Healthcare Centre.