Anticholinergic Drug Use, Serum Anticholinergic Activity, and Adverse Drug Events Among Older People: A Population-Based Study
Anticholinergic Drug Use, Serum Anticholinergic Activity, and Adverse Drug Events Among Older People: A Population-Based Study
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DOI：
10.1007/s40266-013-0063-2
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发表时间：
2013-05-01
期刊：
影响因子：
2.8
通讯作者：
Hartikainen, Sirpa
中科院分区：
文献类型：
--
作者：
Lampela, Pasi;Lavikainen, Piia;Hartikainen, Sirpa
背景 血清抗胆碱能活性（SAA）测定已用于量化患者的抗胆碱能负荷。此外，还制定了几个抗胆碱能药物排名清单来评估抗胆碱能药物负担。目的本研究调查了三个抗胆碱能药物排名清单（卡纳汉抗胆碱能药物量表、鲁道夫抗胆碱能风险量表和周清单）的SAA测定结果和分数是否与老年人的抗胆碱能药物不良事件（ADE）相关。方法我们分析了基于人群的参与者的数据。芬兰库奥皮奥老年多学科良好老年人护理研究（n = 621）。人口统计、诊断和药物使用数据是通过标准化访谈收集的，并根据医疗记录进行验证。使用经过验证的技术评估视力、功能能力、认知和情绪。 SAA 是从血液样本中测量的。结果 SAA 与抗胆碱能 ADE 无关。使用这三个列表中的每一个计算的抗胆碱能药物负荷与患有和不患有痴呆症的人的短距离视力（p \ 0.01）、日常生活活动（p \ 0.05）和日常生活工具活动（p \ 0.05）呈负相关。此外，较差的简易精神状态检查和较差的老年抑郁量表评分与非痴呆患者的抗胆碱能药物负担相关（p\0.05-p\0.001）。使用 Carnahan 和 Chew 制定的列表时，抗胆碱能药物负荷与 ADE 之间的关联最强。结论 从抗胆碱能药物排名列表中获得的分数与临床显着的抗胆碱能 ADE 相关，但 SAA 则不然。这一发现支持这些列表有助于识别临床实践中面临抗胆碱能 ADE 风险的患者。
Background The serum anticholinergic activity (SAA) assay has been used to quantify patients' anticholinergic load. In addition, several ranked lists of anticholinergic drugs have been developed to assess anticholinergic drug burden.Objective This study investigated whether SAA assay results and scores from three ranked lists of anticholinergic drugs (Carnahan's Anticholinergic Drug Scale, Rudolph's Anticholinergic Risk Scale, and Chew's list) are associated with anticholinergic adverse drug events (ADEs) in older people.Methods We analyzed data from participants in the population-based Geriatric Multidisciplinary Good Care of the Elderly Study in Kuopio, Finland (n = 621). Demographic, diagnostic, and drug use data were collected during standardized interviews and verified from medical records. Vision, functional capacity, cognition, and mood were assessed using validated techniques. The SAA was measured from blood samples.Results The SAA was not associated with anticholinergic ADEs. Anticholinergic drug burden computed using each of the three lists was inversely associated with short-distance vision (p\0.01), activities of daily living (p\0.05), and instrumental activities of daily living (p\0.05) in persons with and without dementia. Furthermore, poorer Mini Mental State Examination and poorer Geriatric Depression Scale scores were associated with the anticholinergic drug burden in persons without dementia (p\0.05-p\0.001). The association between anticholinergic drug burden and ADEs was strongest when using the lists developed by Carnahan and Chew.Conclusions Scores obtained from ranked lists of anticholinergic drugs were associated with clinically significant anticholinergic ADEs but the SAA was not. This finding supports the usefulness of these lists to help identify patients at risk of anticholinergic ADEs in clinical practice.