Older adults often prescribed meds linked to higher side effect risks

March 27, 2018, University of Minnesota

Drugs with high-risk anticholinergic properties can lead to risks of developing serious adverse events, such as cognitive impairment, falls, dementia, and even mortality in older adults. Yet, relatively little is known about prescribing trends of high-risk anticholinergic medications in the United States of America.

Researchers in the University of Minnesota College of Pharmacy conducted a repeated cross-sectional analysis of the 2006-2015 National Ambulatory Medical Care Survey to understand more.

They found that physicians' prescribing behavior remained stable over time, and these drugs were prescribed in about six percent of visits over a ten-year period. The findings were recently published in the Journal of the American Geriatrics Society.

"High-risk anticholinergic prescribing should be avoided because there are safer alternative medications for ," said the lead study author, Greg Rhee, Ph.D., M.S.W., adjunct assistant professor in the College of Pharmacy.

Anticholinergic medications block the neurotransmitter acetylcholine, which is part of the nervous system and plays a role in involuntary muscle contractions. These drugs are often prescribed for urinary, respiratory and gastrointestinal disorders. They're also often used to treat depression.

"Older are vulnerable to these medications due in part to physiological changes as they age. In general, older adults have a higher likelihood of developing from taking multiple medications," Rhee said.

The research team investigated whether prescribing patterns of high-risk anticholinergic drugs have changed over time and whether these patterns vary by physician specialty and anticholinergic class among older adults in their office-based care. They also estimated demographic and clinical correlates factors independently associated with these high-risk anticholinergic .

They found:

  • six percent of doctors' visits studied within the survey period listed an anticholinergic medication - suggesting he prescribing pattern varies by physician specialty (e.g., psychiatrists and urologists had higher rates of listing an anticholinergic medication);
  • that by medication class, antidepressants were the most prevalent among anticholinergic drugs prescribed to older adults;
  • women were more likely to receive high-risk anticholinergic prescriptions;
  • patients from the South were more likely to receive high-risk anticholinergic prescriptions;
  • patients with prescribed six or more medications had a greater likelihood of being prescribed high-risk anticholinergic prescriptions.

The research team acknowledged the study had limitations. The survey does not include emergency department or hospital visits. Therefore, the study results may actually underestimate the full impact.

Rhee noted that the prevalence of high-risk anticholinergic prescriptions was stable over time, but varied by physician specialty and class. He recommends increasing awareness of potential adverse effects and encouraging providers to prescribe less-risky medications.

Explore further: Anticholinergic cognitive burden scale IDs adverse outcomes

More information: Taeho Greg Rhee et al, National Prescribing Trends for High-Risk Anticholinergic Medications in Older Adults, Journal of the American Geriatrics Society (2018). DOI: 10.1111/jgs.15357

Related Stories

Anticholinergic cognitive burden scale IDs adverse outcomes

November 28, 2017
(HealthDay)—For older adults, the Anticholinergic Cognitive Burden Scale (ACB) shows good dose-response relationships between anticholinergic burden and adverse outcomes, according to a study published in the November/December ...

Commonly prescribed medication linked to stroke

February 15, 2018
Medication routinely prescribed for common complaints including allergies, heart disease and Parkinson's has been linked to an increased risk of stroke according to new research from the University of Aberdeen.

Anticholinergics may not be best choice for rehab patients with dementia

January 28, 2016
During rehabilitation following an acute hospital stay, medications that block neurotransmitters may be overprescribed to older patients suffering from delirium superimposed on dementia, according to health researchers.

Use of anticholinergic drugs does not increase risk for dementia in Parkinson's disease patients

January 4, 2016
Recent evidence has shown a greater risk of dementia, in particular Alzheimer's disease (AD), in individuals using anticholinergic medications regularly. These drugs are widely used by older adults to treat bladder dysfunction, ...

Commonly used drugs lead to more doctor's office, hospital and emergency department visits

December 20, 2016
Anticholinergic medications, a class of drugs very commonly used by older adults, are linked to an increased rate of emergency department and hospital utilization in the United States, according to an Indiana University Center ...

Recommended for you

Survey reveals how we use music as a possible sleep aid

November 14, 2018
Many individuals use music in the hope that it fights sleep difficulties, according to a study published November 14 in the open-access journal PLOS ONE by Tabitha Trahan of the University of Sheffield, UK, and colleagues. ...

Colder, darker climates increase alcohol consumption and liver disease

November 14, 2018
Where you live could influence how much you drink. According to new research from the University of Pittsburgh Division of Gastroenterology, people living in colder regions with less sunlight drink more alcohol than their ...

Want to cut down on your meds? Your pharmacist can help.

November 14, 2018
Pharmacists are pivotal in the process of deprescribing risky medications in seniors, leading many to stop taking unnecessary sleeping pills, anti-inflammatories and other drugs, a new Canadian study has found.

Your heart hates air pollution. Portable filters could help

November 13, 2018
Microscopic particles floating in the air we breathe come from sources such as fossil fuel combustion, fires, cigarettes and vehicles. Known as fine particulate matter, this form of air pollution increases the risk of cardiovascular ...

No accounting for these tastes: Artificial flavors a mystery

November 13, 2018
Six artificial flavors are being ordered out of the food supply in a dispute over their safety, but good luck to anyone who wants to know which cookies, candies or drinks they're in.

Simple tips can lead to better food choices

November 13, 2018
A few easily learned tips on eating and food choice can increase amount of healthy food choices between 5 percent and 11 percent, a new Yale University study has found.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.