Korean J Intern Med.
2022 Mar;37(2):468-477. 10.3904/kjim.2021.457.
Factors associated with anticholinergic burden among older patients in long-term care hospitals in Korea
- Affiliations
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- 1Division of Geriatrics, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
- 2Department of Public Health Sciences, Graduate School of Public Health, Seoul National University, Seoul, Korea
- 3Institute of Health and Environment, Seoul National University, Seoul, Korea
- 4Institute on Aging, Seoul National University, Seoul, Korea
- 5Department of Environmental Health, Korea National Open University, Seoul, Korea
- 6Office of eHealth Research and Businesses, Seoul National University Bundang Hospital, Seongnam, Korea
- 7Department of Rehabilitation Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
- 8Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul, Korea
- 9Department of Pharmacy, Seoul National University Bundang Hospital, Seongnam, Korea
- 10Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
- KMID: 2527310
- DOI: http://doi.org/10.3904/kjim.2021.457
Abstract
- Background/Aims
Drugs with anticholinergic properties (DAPs) are associated with adverse health outcomes in older patients. The objective of this study was to evaluate the factors that determine the prescribing of more DAPs in long-term care hospitals (LTCHs) in Korea. In addition, the current patterns of DAP prescription were explored using a novel platform, which can collect data from LTCHs.
Methods
This was a Health-RESPECT (integrated caRE Systems for elderly PatiEnts using iCT) sub-study, which is a pragmatic, cluster-randomized, controlled trial. The Health-RESPECT platform was used to collect prescribed medication data of 466 patients (aged ≥ 65 years) from seven LTCHs. DAPs were identified using the Korean Anticholinergic Burden Scale (KABS). Physical frailty, cognitive function, functional status, and quality of life were evaluated.
Results
Among 466 LTCH patients, 88.8% (n = 414) were prescribed DAPs, and the prevalence of high KABS (≥ 3) was 70.4% (n = 328). The drugs that contributed most to the total KABS were quetiapine (20.7%), chlorpheniramine (19.5%), tramadol (9.8%), cimetidine (5.8%), and furosemide (3.6%). Polypharmacy, higher body mass index, less dependence, better communication and cognitive functions, and poorer quality of life were associated with high KABS.
Conclusions
Although the patients with a high burden of DAPs were less dependent and had better cognitive and communication functions, they had poorer quality of life. DAP use in LTCH patients should be monitored carefully, and the risk/ benefit relationship for their use should be considered.
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