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Can medication management review reduce anticholinergic burden (ACB) in the elderly? Encouraging results from a theoretical model

He, Zikai and Ball, Patrick A. (2013). Can medication management review reduce anticholinergic burden (ACB) in the elderly? Encouraging results from a theoretical model. International Psychogeriatrics,25(9):1425-1431.

Document type: Journal Article
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IRMA ID 82794376xPUB164
Title Can medication management review reduce anticholinergic burden (ACB) in the elderly? Encouraging results from a theoretical model
Author He, Zikai
Ball, Patrick A.
Journal Name International Psychogeriatrics
Publication Date 2013
Volume Number 25
Issue Number 9
ISSN 1741-203X   (check CDU catalogue  open catalogue search in new window)
Scopus ID 2-s2.0-84881065900
Start Page 1425
End Page 1431
Total Pages 7
Place of Publication United Kingdom
Publisher Global Science Press
HERDC Category C1 - Journal Article (DIISR)
Abstract Background:
Review of recent journal articles and various relevant current textbooks provides strong evidence to show that anticholinergic burden is a material issue in frail and at-risk patients. This study assesses the anticholinergic burden in a group of patients in residential care facilities and then applies a theoretical intervention model. It is based on a scoring system known as the Anticholinergic Cognitive Burden (ACB) scale, and attempts to reduce the anticholinergic burden while maintaining therapeutic benefits.

Methods:
A database of 691 patients was analyzed for each individual's ACB based on the scale of scoring produced by groups of experts in the area. A theoretical intervention was then conducted using relevant, evidence-based practice guidelines for clinical therapeutics in Australia. The intervention had the aim of reducing the total ACB without affecting the apparent intended effectiveness of the prescribed therapy.

Results:

Of the 35% (n = 242) patients who score at least 1 point on the ACB, a reduction is achievable in 59% of the cases. In particular, the reduction from a clinically significant score of 3 or above to 2 or below for 49 of those patients is possible in 85% of the cases. Overall, this represents a reduction from 7.10% to 1.01% for the entire population. It is also found that of the 246,960 counts of items dispensed (both prescription and non-prescription) for these patients, 47,334 (or 19.2%) of these were of agents on the ACB scale.

Conclusions:

The study found that it appears to be possible that the total ACB of a group of 691 patients can be significantly reduced.
Keywords ACB
Anticholinergic agents
Anticolinergics
Cognitive burden
Reduction
DOI http://dx.doi.org/10.1017/S1041610213000872   (check subscription with CDU E-Gateway service for CDU Staff and Students  check subscription with CDU E-Gateway in new window)
Additional Notes © Cambridge University Press


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