College of Pharmacy and Research Institute of Pharmaceutical Sciences, Seoul National University, Seoul, Korea.
College of Pharmacy and Institute of Pharmaceutical Science and Technology, Hanyang University, Ansan, Korea.
Geriatr Gerontol Int. 2019 Jul;19(7):628-634. doi: 10.1111/ggi.13680. Epub 2019 Apr 29.
The aim of this study was to develop the Korean Anticholinergic Burden Scale through assessment of previously developed tools, a literature review and a modified Delphi process.
We carried out a systematic review to identify previously published anticholinergic burden tools. A composite medication list was made by extracting medications and their quantitative grading from the existing tools, after excluding the medications not distributed in Korea and topical agents. We also added medications available in Korea that had not been rated. For medications with conflicting anticholinergic scores or no anticholinergic score, we determined the final score from 0 ("no anticholinergic effect") to 3 ("strong anticholinergic effect") with a literature review and expert consensus through a two-round Delphi process.
A composite list of 655 medications with anticholinergic scores was extracted from 10 existing tools. A total of 38 medications available in Korea were added to the list. A total of 494 medications were deemed suitable for a Korean-specific scale. We confirmed the anticholinergic scores of 352 medications from existing scales, and 142 underwent the Delphi process. The final scores graded by experts showed high reliability among experts with an intra-class correlation of 0.98 (95% confidence interval 0.97-0.98). Finally, 56 medications were categorized as strong anticholinergics, 23 as moderate, 59 as weak and 356 as having no anticholinergic activity.
This newly created consensus-driven anticholinergic burden scale designed specifically for the Korean healthcare system might be a practical tool for assessing anticholinergic burden in older adults with polypharmacy in routine medication reviews and in research. Geriatr Gerontol Int 2019; 19: 628-634.
本研究旨在通过评估先前开发的工具、文献回顾和改良 Delphi 法来开发韩国抗胆碱能负担量表。
我们进行了系统评价，以确定先前发表的抗胆碱能负担工具。通过从现有工具中提取药物及其定量分级（排除未在韩国分布的药物和局部制剂），制作了一个综合药物清单。我们还添加了在韩国可获得但未被评级的药物。对于抗胆碱能评分存在冲突或无抗胆碱能评分的药物，我们通过文献回顾和两轮 Delphi 法的专家共识，将最终评分确定为 0（“无抗胆碱能作用”）至 3（“强抗胆碱能作用”）。
从 10 种现有工具中提取了具有抗胆碱能评分的 655 种药物的综合清单。共添加了 38 种韩国可获得的药物。共有 494 种药物被认为适合韩国特有的量表。我们从现有量表中确认了 352 种药物的抗胆碱能评分，其中 142 种药物进行了 Delphi 法。专家的最终评分显示专家之间具有高度可靠性，组内相关系数为 0.98（95%置信区间 0.97-0.98）。最后，56 种药物被归类为强抗胆碱能药，23 种为中度，59 种为弱，356 种无抗胆碱能活性。
专为韩国医疗保健系统设计的这种新的共识驱动的抗胆碱能负担量表可能是在常规药物评估和研究中评估老年人群中多种药物治疗的抗胆碱能负担的实用工具。
老年医学与老年病学国际杂志 2019; 19: 628-634.
