Falls, confusion, cognitive decline, dry mouth, constipation, and urinary retention. In a new episode of the NPS MedicineWise podcast released today, Dr. Kate Annear, NPS MedicineWise medical advisor and general practitioner, discusses the new NPS MedicineWise educational program on the cumulative effects of anticholinergic drugs. Examining people’s multiple medications and considering deprescribing or finding alternative treatments can reduce the “anticholinergic burden.”
“Drugs with an anticholinergic effect are useful in treating many conditions such as depression, behavior change dementia and chronic non-cancer pain,” says Dr. Kate Annear, medical advisor and general practitioner NPS MedicineWise.
“However, cumulatively, they can cause serious side effects that are particularly problematic for older people who may be more sensitive to the anticholinergic load and who may take multiple drugs.
“It is important to keep the anticholinergic load in mind. It’s easy for older people who have symptoms to blame them on just getting older, ”she says.
The burden of anticholinergics is associated with poor health outcomes, especially in the elderly, including a 60% increase in fall-related hospitalizations, a 50% increase in the risk of dementia, and a 30% increase in mortality.
The NPS MedicineWise Anticholinergic burden: unintended consequences for the elderly The program aims to improve the health outcomes of older people living in community and residential care facilities for the elderly (RACF) by promoting the safe and effective use of drugs with anticholinergic effects and, therefore, reducing the burden. anticholinergic.
A Home Medication Review (HMR) or Residence Medication Management Review (RMMR) if the person lives in a nursing home is an important way to review medications. It is important that the GP provides the pharmacist with a detailed referral to get the most out of the examination. Demographic and social history, medical and surgical history, relevant pathology findings, and a complete list of medications with indications are all important.
Dr Kate Annear, Medical Advisor, NPS MedicineWise
The program includes resources to support conversations with patients about anticholinergics, deprescribing, and medication reviews, including an information sheet, decision support, action plan, and Choosing Wisely 5 Questions ‘a person can ask about anticholinergic drugs.
There is also a report for GPs participating in the MedicineInsight program, providing them with individualized data on their patients who are exposed to a high anticholinergic load. The report is based on the Drug Burden Index (DBI), which is a measure of cumulative exposure to anticholinergic and sedative drugs. Professor Sarah Hilmer, Dr Lisa Kouladjian O’Donnell and Associate Professor Danijela Gnjidic, supported by the Northern Sydney Local Health District and the University of Sydney Faculty of Medicine and Health, provided related expertise and resources to the DBI to inform the report.
Visit the NPS MedicineWise website for more information and resources for healthcare professionals and consumers of the Anticholinergic burden: unintended consequences for the elderly program.