Abstract
The aging population is often burdened with multiple comorbidities, leading to polypharmacy, which increases risk of adverse drug reactions .
Anticholinergic medications are commonly prescribed to elderly patients for various conditions, yet they are associated with a range of adverse effects, including cognitive impairment, falls, and even increased mortality.
The Anticholinergic Burden (ACB) score is a validated tool used to assess the cumulative burden of anticholinergic medications in patients. This clinical audit is aimed to evaluate the use of the Anticholinergic Burden (ACB) score as a tool to identify and manage anticholinergic burden in elderly patients within a hospital setting.
Method: A retrospective analysis was conducted on a cohort of elderly patients (> 65 years of age) admitted under orthogeri in the month of June 2023 which yielded a sample size of 33 patients using various data related patients congnition and demographics, medical history, medication
Results: Data revealed that 36% of elderly patients had impaired cognition And ACB scores were not calculated despite them being on anticholinergic drugs even though investigations of possible causes of cognitive impairment were done and ruled out as possible cause Further analysis revealed a significant correlation between ACB scores and cognition. Patients with high ACB score were nearly 3 times as likely to be confused and patients ACB score of 2 were more than twice as likely to be confused.
Data also revealed that the most common drugs contributing to anti-cholinergic burden Lansoprazole (18%) Analgesics (15%) - out of which 60% came from Codeine
Conclusion: ACB score is an efficient tool to better manage the effect of polypharmacy on the elderly .
it is important to flag high ACB scores in order to optimize medication by prescribing alternative drugs with low anti - cholinergic burden .