Size of the associations between anticholinergic burden tool scores and adverse outcomes in older patients
| Autor: | Isabel Vitória Figueiredo, Fernando Fernandez-Llimos, Manuel Teixeira Veríssimo, Ana C. Cabral, Marta Lavrador, Margarida Castel-Branco |
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| Rok vydání: | 2020 |
| Předmět: |
Male
medicine.medical_specialty medicine.drug_class Psychological intervention Pharmaceutical Science Pharmacy Toxicology 030226 pharmacology & pharmacy Cholinergic Antagonists 03 medical and health sciences 0302 clinical medicine Internal medicine medicine Anticholinergic Humans Cognitive Dysfunction Pharmacology (medical) 030212 general & internal medicine Adverse effect Aged Aged 80 and over Pharmacology Receiver operating characteristic business.industry Area under the curve Dry mouth Hospitalization Case-Control Studies Accidental Falls Female medicine.symptom business Risk assessment |
| Popis: | Background Several anticholinergic scales and equations to evaluate the anticholinergic burden have been previously created. Association of these instruments with the anticholinergic outcomes are usually estimated by means of hypothesis contrast tests, which ignore the size of the association effect. Objective To evaluate the effect size of the associations between the scores on cumulative anticholinergic burden instruments with peripheral or central anticholinergic adverse outcomes in older patients. Setting Internal medicine ward of a Tertiary University Hospital. Methods A case–control study was conducted in patients over 65 years who were admitted to two internal medicine wards of a Portuguese university hospital. The Anticholinergic Drug Scale, Anticholinergic Risk Scale, Anticholinergic Cognitive Burden scale and Drug Burden Index were used to calculate the patients’ anticholinergic burden. Peripheral (dry mouth—swab technique; dry eye—Schirmer test) and central (falls and cognitive impairment—Mini-Mental State Examination) anticholinergic adverse outcomes were investigated. The Barthel Index was used to assess overall physical functionality. The Mann–Whitney test was used to evaluate probabilistic differences in the anticholinergic scores between case and control individuals. To establish the effect size of the associations, the area under the curve of the receiver operating characteristics curve was calculated. Main outcome measure Anticholinergic adverse effects. Results A total of 250 patients (mean age 81.67 years, standard deviation 7.768; 50% females) were included. In total, 148 patients (59.2%) presented with dry mouth, 85 (34%) with dry eye, 141 (56.4%) with impaired functionality, 44 (17.6%) with a history of falls and 219 (87.6%) with cognitive impairment. Significant differences (p |
| Databáze: | OpenAIRE |
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