TY  - JOUR
PY  - 2023//
TI  - Polypharmacy and associated cumulative anticholinergic burden are important predictors of falls risk
JO  - British journal of clinical pharmacology
A1  - Wong, Ho Lun
A1  - Mandal, Amit K. J.
A1  - Weaver, Claire
A1  - Chauhan, Rahul
A1  - Missouris, Constantinos G.
SP  - ePub
EP  - ePub
VL  - ePub
IS  - ePub
N2  - It is evident that polypharmacy among older adults results in increased cumulative anticholinergic exposure and several adverse outcomes. We read with interest and congratulate Hilmer et al. on their multicentre cohort study in Australia, investigating the association between cumulative anticholinergic and sedative medication exposure and adverse outcomes. The authors conclude that potentially inappropriate medications (PIMS) and drug burden index (DBI) are significantly associated with increased risks of fall and delirium.1    We would like to share our experience from the United Kingdom where polypharmacy is a known and growing phenomenon associated with adverse effects in older adults.2 We investigated the potential confounding effects of polypharmacy and cumulative anticholinergic burden (ACB) in older adults hospitalized with fall.     We prospectively evaluated 411 consecutive patients aged ≥65 years (mean age 83.8 ± 8.0 years: 40.6% male) admitted acutely to hospital. Pharmacological reconciliation was carried out by hospital pharmacists utilizing the national patient database: NHS Summary Care Record, which contains all regular and acute medication prescriptions. Incidence of polypharmacy (defined as prescription of ≥5 regular oral medications), ACB score (http://www.acbcalc.com/) and Charlson Comorbidity Index (CCI) were recorded and compared between patients admitted with or without fall. We further evaluated the association between polypharmacy, summative ACB score, CCI, age and falls risk...<p />  <p>Language: en</p>
LA  - en
SN  - 0306-5251
UR  - http://dx.doi.org/10.1111/bcp.15753
ID  - ref1
ER  -