An anticholinergic burden score for German prescribers: score development.
An anticholinergic burden score for German prescribers: score development.
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DOI：
10.1186/s12877-018-0929-6
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发表时间：
2018-10-11
期刊：
影响因子：
4.1
通讯作者：
Drey M
中科院分区：
文献类型：
--
作者：
Kiesel EK;Hopf YM;Drey M
抗胆碱能药物使老年患者发生福尔斯、认知能力下降和谵妄以及口干或便秘等外周不良反应的风险更高。处方医生往往不知道他们的患者的药物为基础的抗胆碱能负担（ACB）。本研究旨在为临床医生在处方水平使用的在德国获得许可的药物制定抗胆碱能负担评分。在pubmed中进行的系统性文献检索评估了先前发表的ACB工具。提取定量分级评分，减少到德国可用的药物，并通过专家讨论重新评估。将药物评分为无、弱、中度或强抗胆碱能作用。在临床常规中确定了其他药物，并纳入。文献检索确定了692种不同的药物，其中548种药物在德国可用。在排除因无全身效应或药物组合评分而导致的药物（n = 67）并评价临床常规中的26种其他已识别药物后，对504种药物进行了评分。其中，356种药物被归类为没有，104种药物被评为弱，18种为中度，29种为强抗胆碱能作用。新创建的德国授权药物ACB评分可用于日常临床实践，以减少老年患者可能不适当的用药。进一步的临床研究调查其减少抗胆碱能副作用的效果是必要的验证。本文的在线版本（10.1186/s12877-018-0929-6）包含补充材料，可供授权用户使用。
Anticholinergic drugs put elderly patients at a higher risk for falls, cognitive decline, and delirium as well as peripheral adverse reactions like dry mouth or constipation. Prescribers are often unaware of the drug-based anticholinergic burden (ACB) of their patients. This study aimed to develop an anticholinergic burden score for drugs licensed in Germany to be used by clinicians at prescribing level. A systematic literature search in pubmed assessed previously published ACB tools. Quantitative grading scores were extracted, reduced to drugs available in Germany, and reevaluated by expert discussion. Drugs were scored as having no, weak, moderate, or strong anticholinergic effects. Further drugs were identified in clinical routine and included as well. The literature search identified 692 different drugs, with 548 drugs available in Germany. After exclusion of drugs due to no systemic effect or scoring of drug combinations (n = 67) and evaluation of 26 additional identified drugs in clinical routine, 504 drugs were scored. Of those, 356 drugs were categorised as having no, 104 drugs were scored as weak, 18 as moderate and 29 as having strong anticholinergic effects. The newly created ACB score for drugs authorized in Germany can be used in daily clinical practice to reduce potentially inappropriate medications for elderly patients. Further clinical studies investigating its effect on reducing anticholinergic side effects are necessary for validation. The online version of this article (10.1186/s12877-018-0929-6) contains supplementary material, which is available to authorized users.
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