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 ...

Commonly used medications associated with impaired physical function in older adults

May 4, 2008
Older adults who take drugs designed to block the neurotransmitter acetylcholine – including common medications for incontinence, high blood pressure and allergies – are more likely to be dependent in one or more activities ...

Recommended for you

India launches 'Modicare', world's biggest health scheme

September 23, 2018
Prime Minister Narendra Modi on Sunday launched the world's biggest health insurance scheme, promising free coverage for half a billion of India's poorest citizens ahead of national elections next year.

Alcohol responsible for one in 20 deaths worldwide: WHO

September 21, 2018
Alcohol kills three million people worldwide each year—more than AIDS, violence and road accidents combined, the World Health Organization said Friday, adding that men are particularly at risk.

Patient-centered visual aid helps physicians discuss risks, treatments with parents

September 21, 2018
A series of illustrations and charts designed as decision aids for parents of children with minor head injuries helped them communicate with emergency medicine physicians and make informed decisions about their child's care, ...

Smart pills dumb down medical care, experts warn

September 21, 2018
Enthusiasm for an emerging digital health tool, the smart pill, is on the rise but researchers at the University of Illinois at Chicago have published a paper in the American Journal of Bioethics that cautions health care ...

Crunched for time? High-intensity exercise = same cell benefits in fewer minutes

September 20, 2018
A few minutes of high-intensity interval or sprinting exercise may be as effective as much longer exercise sessions in spurring beneficial improvements in mitochondrial function, according to new research. The small study ...

China's doctor shortage prompts rush for AI health care

September 20, 2018
Qu Jianguo, 64, had a futuristic medical visit in Shanghai as he put his wrist through an automated pulse-taking machine and received the result within two minutes on a mobile phone—without a doctor present.

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.