Okoro Roland Nnaemeka, Idris Algoni Idris
Department of Clinical Pharmacy and Pharmacy Administration, University of Maiduguri, Maiduguri, Nigeria.
J Med Access. 2022 Jul 29;6:27550834221112753. doi: 10.1177/27550834221112753. eCollection 2022 Jan-Dec.
Anticholinergic medications which are commonly prescribed to older adults can produce more pronounced adverse effects compared to the younger population.
To investigate the prevalence of polypharmacy, describe the prescription patterns of anticholinergic medications, determine the prevalence of exposure to high-risk anticholinergic cognitive burden (ACB) medications, and identify the potential predictors of exposure to high-risk ACB medications in older adults in a Nigerian secondary hospital.
This cross-sectional study that included older adults prescribed at least one anticholinergic medication was conducted at a secondary care hospital in Nigeria. The study data were initially summarized using descriptive statistics, whereas multivariable logistic regression analysis was used to identify the potential predictors of exposure to high-risk ACB medications. In this study, the cumulative ACB scores were dichotomized into low risk (score 1-2) and high risk (score ⩾ 3). A value less than 0.05 was considered to be statistically significant.
A total of 256 older adults were included in this study; 113 (44.1%) had polypharmacy, whereas 26.6% (188/256) were exposed to high-risk ACB medications. Of a total of 391 anticholinergic medications used by the population, furosemide (36.57%) was the most commonly prescribed. The adjusted multivariable logistic regression analysis indicated that patients who had acute diseases were 2.5 times (adjusted odds ratio (AOR) = 2.49, 95% confidence interval (CI): 1.40-4.45) more likely to be exposed to high-risk ACB medications than those with chronic diseases.
The study demonstrates a high prevalence of polypharmacy and exposure to high-risk ACB medications suggesting the need for pharmaceutical care in this high-risk population. Older adults' exposure to high-risk ACB medications was significantly associated with prescriptions for acute diseases.
与年轻人群相比，通常开给老年人的抗胆碱能药物会产生更明显的不良反应。
调查多重用药的患病率，描述抗胆碱能药物的处方模式，确定接触高风险抗胆碱能认知负担（ACB）药物的患病率，并确定尼日利亚一家二级医院中老年人接触高风险ACB药物的潜在预测因素。
这项横断面研究纳入了至少开具了一种抗胆碱能药物的老年人，在尼日利亚的一家二级护理医院进行。研究数据最初使用描述性统计进行总结，而多变量逻辑回归分析用于确定接触高风险ACB药物的潜在预测因素。在本研究中，累积ACB评分被分为低风险（评分1 - 2）和高风险（评分⩾3）。P值小于0.05被认为具有统计学意义。
本研究共纳入256名老年人；113名（44.1%）患有多重用药，而26.6%（188/256）接触高风险ACB药物。在人群使用的总共391种抗胆碱能药物中，呋塞米（36.57%）是最常开具的。调整后的多变量逻辑回归分析表明，患有急性疾病的患者接触高风险ACB药物的可能性是患有慢性疾病患者的2.5倍（调整后的优势比（AOR）= 2.49，95%置信区间（CI）：1.40 - 4.45）。
该研究表明多重用药和接触高风险ACB药物的患病率很高，这表明在这个高风险人群中需要药物治疗护理。老年人接触高风险ACB药物与急性疾病的处方显著相关。
