Literature DB >> 28091711

Anticholinergic prescription: are healthcare professionals the real burden?

George Araklitis1, Ganesh Thiagamoorthy2, Jo Hunter2, Angie Rantell2, Dudley Robinson2, Linda Cardozo2.   

Abstract

INTRODUCTION AND HYPOTHESIS: Anticholinergic medication is the medical treatment for overactive bladder (OAB). These drugs can act on the central nervous system and can lead to cognitive decline, dementia, and potentially death. Patients taking drugs with anticholinergic effects increase their anticholinergic burden-defined as the cumulative effect of taking one or more drugs that can have adverse effects. When prescribing anticholinergic medication for the elderly, we must choose the right drug. We aimed to discover the level of understanding on this subject and its application to real clinical practice amongst our healthcare professionals (HCPs).
METHODS: An 18-point questionnaire was distributed to urogynaecologists, general gynaecologists, urologists, geriatricians, general practitioners (GPs), and nurse specialists to assess knowledge on the subject.
RESULTS: A total of 96 HCPs completed the questionnaire. The nurse specialists had the highest score in identifying that oxybutynin was the drug most likely to cross the blood-brain barrier (BBB). The urogynaecologists had the highest score in identifying that trospium chloride was least likely to cross the BBB, whereas the GPs had the lowest score. Solifenacin was the most popular anticholinergic drug prescribed in the elderly without dementia. Trospium chloride was the most popular drug prescribed in the elderly with dementia.
CONCLUSIONS: We have found that knowledge is lacking amongst all our HCPs, but especially amongst our first-line doctors, our GPs. Education is key in developing knowledge and safe prescribing, to improve the care we give to our patients.

Entities:  

Keywords:  Anticholinergic burden; Anticholinergic load; Anticholinergic medication; Dementia; Overactive bladder

Mesh:

Substances:

Year:  2017        PMID: 28091711     DOI: 10.1007/s00192-016-3258-3

Source DB:  PubMed          Journal:  Int Urogynecol J        ISSN: 0937-3462            Impact factor:   2.894


  17 in total

Review 1.  Anticholinergics for overactive bladder therapy: central nervous system effects.

Authors:  Michael Chancellor; Timothy Boone
Journal:  CNS Neurosci Ther       Date:  2011-02-16       Impact factor: 5.243

2.  Systematic review of anticholinergic risk scales in older adults.

Authors:  Carlos E Durán; Majda Azermai; Robert H Vander Stichele
Journal:  Eur J Clin Pharmacol       Date:  2013-03-26       Impact factor: 2.953

Review 3.  Systematic review on the use of anticholinergic scales in poly pathological patients.

Authors:  Angela Maria Villalba-Moreno; Eva Rocío Alfaro-Lara; Maria Concepción Pérez-Guerrero; Maria Dolores Nieto-Martín; Bernardo Santos-Ramos
Journal:  Arch Gerontol Geriatr       Date:  2015-10-14       Impact factor: 3.250

4.  How widespread are the symptoms of an overactive bladder and how are they managed? A population-based prevalence study.

Authors:  I Milsom; P Abrams; L Cardozo; R G Roberts; J Thüroff; A J Wein
Journal:  BJU Int       Date:  2001-06       Impact factor: 5.588

5.  Cumulative use of strong anticholinergics and incident dementia: a prospective cohort study.

Authors:  Shelly L Gray; Melissa L Anderson; Sascha Dublin; Joseph T Hanlon; Rebecca Hubbard; Rod Walker; Onchee Yu; Paul K Crane; Eric B Larson
Journal:  JAMA Intern Med       Date:  2015-03       Impact factor: 21.873

Review 6.  Blood-brain barrier permeation and efflux exclusion of anticholinergics used in the treatment of overactive bladder.

Authors:  Michael B Chancellor; David R Staskin; Gary G Kay; Bobby W Sandage; Michael G Oefelein; Jack W Tsao
Journal:  Drugs Aging       Date:  2012-04-01       Impact factor: 3.923

Review 7.  Antimuscarinic agents: implications and concerns in the management of overactive bladder in the elderly.

Authors:  Gary G Kay; Lisa J Granville
Journal:  Clin Ther       Date:  2005-01       Impact factor: 3.393

Review 8.  Acetylcholine and delirium.

Authors:  L E Tune; S Egeli
Journal:  Dement Geriatr Cogn Disord       Date:  1999 Sep-Oct       Impact factor: 2.959

Review 9.  An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for female pelvic floor dysfunction.

Authors:  Bernard T Haylen; Dirk de Ridder; Robert M Freeman; Steven E Swift; Bary Berghmans; Joseph Lee; Ash Monga; Eckhard Petri; Diaa E Rizk; Peter K Sand; Gabriel N Schaer
Journal:  Int Urogynecol J       Date:  2009-11-25       Impact factor: 2.894

10.  Prescribing for older patients: how to avoid toxic drug reactions.

Authors:  I L Salom; K Davis
Journal:  Geriatrics       Date:  1995-10
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  5 in total

Review 1.  The cognitive effect of anticholinergics for patients with overactive bladder.

Authors:  Blayne Welk; Kathryn Richardson; Jalesh N Panicker
Journal:  Nat Rev Urol       Date:  2021-08-24       Impact factor: 14.432

2.  Overactive bladder in an integrated delivery system: a longitudinal cohort study.

Authors:  Jeffrey A Linder; Joel S Weissman; Harry Reyes Nieva; Stuart Lipsitz; R Sterling Haring; Julie DeAngelis; Rita M Kristy; Kevin R Loughlin
Journal:  BMC Health Serv Res       Date:  2020-05-20       Impact factor: 2.655

Review 3.  Anticholinergic Drugs in Geriatric Psychopharmacology.

Authors:  Jorge López-Álvarez; Julia Sevilla-Llewellyn-Jones; Luis Agüera-Ortiz
Journal:  Front Neurosci       Date:  2019-12-06       Impact factor: 4.677

4.  Anticholinergic therapy: A case-based approach.

Authors:  Dudley Robinson; George Araklitis
Journal:  Case Rep Womens Health       Date:  2019-11-19

Review 5.  Treatment of bladder dysfunction with solifenacin: is there a risk of dementia or cognitive impairment?

Authors:  L P Dantas; A R C C Forte; B C Lima; C N S Sousa; E C Vasconcelos; P H C Lessa; R F Vieira; M C A Patrocínio; S M M Vasconcelos
Journal:  Braz J Med Biol Res       Date:  2022-01-25       Impact factor: 2.590

  5 in total

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