Fadare Joseph O, Obimakinde Abimbola Margaret, Aina Felix O, Araromi Ebisola J, Adegbuyi Theophilus Adekunle, Osasona Oluwatoba E, Agbesanwa Tosin A
Department of Pharmacology and Therapeutics, College of Medicine, Ekiti State University, Ado-Ekiti, Nigeria.
Department of Medicine, Ekiti State University Teaching Hospital, Ado-Ekiti, Nigeria.
Front Pharmacol. 2021 Jan 29;12:580152. doi: 10.3389/fphar.2021.580152. eCollection 2021.
The use of drugs with anticholinergic effects among elderly patients is associated with adverse clinical outcomes. There is paucity of information about anticholinergic drug burden among Nigerian elderly population. To determine the anticholinergic drug burden among elderly Nigerian patients. This was a retrospective cross-sectional study conducted among elderly patients (aged 65 and above) who visited the Family Medicine outpatients' clinics of the Ekiti State University Teaching Hospital, Ado-Ekiti, Nigeria between July 1 and October 31, 2018. Information extracted from the case files included patient's age, sex, diagnoses, and list of prescribed medications. Medicines with anticholinergic effects were identified and scored using the anticholinergic drug burden calculator (http://www.acbcalc.com). The medical records of 400 patients were analyzed with females accounting for 60.5% of the study population. The mean age of participants was 73 ± 7.4 years with only 28 (7%) of patients having more than two co-morbid conditions. Polypharmacy was identified in 152 (38%) of the patients while 147 (36.7%) had drugs with anticholinergic effects prescribed. The anticholinergic burden was high in 60 (15%) patients. Polypharmacy was significantly associated with having more than two diagnosed conditions and high anticholinergic burden ( value of < 0 .001 and 0.013 respectively). There was significant correlation between total number of prescribed drugs and count of diagnoses (r = 0.598; < 0 .000) and between total number of prescribed drugs and number of drugs with anticholinergic effects (r = 0 .196; < 0 .000). The anticholinergic burden in this group of elderly Nigerian patients was low; majority (67%) had no exposure to drugs with anticholinergic effects with only 15% having high anticholinergic burden. Polypharmacy and multiple diagnosed conditions were positively associated with high anticholinergic burden. Based on the positive and significant correlations found in this study, a reduction in the number of prescribed medicines especially those with significant anticholinergic effects used for secondary indications may lessen the anticholinergic burden among the elderly.
老年患者使用具有抗胆碱能作用的药物与不良临床结局相关。关于尼日利亚老年人群抗胆碱能药物负担的信息匮乏。为了确定尼日利亚老年患者的抗胆碱能药物负担。这是一项回顾性横断面研究，研究对象为2018年7月1日至10月31日期间前往尼日利亚阿多-埃基蒂埃基蒂州立大学教学医院家庭医学门诊就诊的65岁及以上老年患者。从病历中提取的信息包括患者的年龄、性别、诊断结果和处方药物清单。使用抗胆碱能药物负担计算器（http://www.acbcalc.com）识别并对具有抗胆碱能作用的药物进行评分。分析了400名患者的病历，其中女性占研究人群的60.5%。参与者的平均年龄为73±7.4岁，只有28名（7%）患者患有两种以上的合并症。152名（38%）患者存在多重用药情况，147名（36.7%）患者使用了具有抗胆碱能作用的药物。60名（15%）患者的抗胆碱能负担较高。多重用药与两种以上诊断疾病和高抗胆碱能负担显著相关（分别为P值<0.001和0.013）。处方药物总数与诊断数之间存在显著相关性（r = 0.598；P<0.000），处方药物总数与具有抗胆碱能作用的药物数量之间也存在显著相关性（r = 0.196；P<0.000）。这组尼日利亚老年患者的抗胆碱能负担较低；大多数（67%）患者未接触过具有抗胆碱能作用的药物，只有15%的患者抗胆碱能负担较高。多重用药和多种诊断疾病与高抗胆碱能负担呈正相关。基于本研究发现的正相关和显著相关性，减少处方药物数量，尤其是用于次要适应症的具有显著抗胆碱能作用的药物，可能会减轻老年人的抗胆碱能负担。
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