瑞典抗胆碱能负担量表（Swe-ABS）的开发。
Development of the Swedish anticholinergic burden scale (Swe-ABS).
机构信息
Memory Clinic, Ängelholm, SE-262 52, Sweden.
Cognitive Disorders Research Unit, Department of Clinical Sciences, Lund University, Malmö, Sweden.
出版信息
BMC Geriatr. 2023 Aug 25;23(1):518. doi: 10.1186/s12877-023-04225-1.
BACKGROUND
Drugs with anticholinergic properties are associated with cognitive adverse effects, especially in patients vulnerable to central muscarinic antagonism. A variety of drugs show weak, moderate or strong anticholinergic effects. Therefore, the cumulative anticholinergic burden should be considered in patients with cognitive impairment. This study aimed to develop a Swedish Anticholinergic Burden Scale (Swe-ABS) to be used in health care and research.
METHODS
A systematic literature review was conducted in PubMed and Ovid Embase to identify previously published tools quantifying anticholinergic drug burden (i.e., exposure). Drugs and grading scores (0-3, no to high anticholinergic activity) were extracted from identified lists. Enteral and parenteral drugs authorized in Sweden were included. Drugs with conflicting scores in the existing lists were assessed by an expert group. Two drugs that were not previously assessed were also added to the evaluation process.
RESULTS
The systematic literature search identified the following nine anticholinergic burden scales: Anticholinergic Activity Scale, Anticholinergic Burden Classification, updated Anticholinergic Cognitive Burden scale, Anticholinergic Drug Scale, Anticholinergic Load Scale, Anticholinergic Risk Scale, updated Clinician-rated Anticholinergic Scale, German Anticholinergic Burden Scale and Korean Anticholinergic Burden Scale. A list of drugs with significant anticholinergic effects provided by The Swedish National Board of Health and Welfare was included in the process. The suggested Swe-ABS consists of 104 drugs scored as having weak, moderate or strong anticholinergic effects. Two hundred and fifty-six drugs were listed as having no anticholinergic effects based on evaluation in previous scales. In total, 62 drugs were assessed by the expert group.
CONCLUSIONS
Swe-ABS is a simplified method to quantify the anticholinergic burden and is easy to use in clinical practice. Publication of this scale might make clinicians more aware of drugs with anticholinergic properties and patients' total anticholinergic burden. Further research is needed to validate the Swe-ABS and evaluate anticholinergic exposure versus clinically significant outcomes.
背景
具有抗胆碱能特性的药物与认知不良反应有关，尤其是在易受中枢毒蕈碱拮抗作用影响的患者中。各种药物表现出弱、中或强的抗胆碱能作用。因此，在认知障碍患者中应考虑累积的抗胆碱能负担。本研究旨在开发一种用于医疗保健和研究的瑞典抗胆碱能负担量表（Swe-ABS）。
方法
在 PubMed 和 Ovid Embase 中进行系统文献回顾，以确定先前发表的用于量化抗胆碱能药物负担（即暴露）的工具。从已确定的清单中提取药物和分级评分（0-3，无至高抗胆碱能活性）。瑞典授权的肠内和肠外药物均包括在内。对现有清单中评分有冲突的药物由专家组进行评估。还将两种以前未评估的药物纳入评估过程。
结果
系统文献检索确定了以下 9 种抗胆碱能负担量表：抗胆碱能活性量表、抗胆碱能负担分类、更新的抗胆碱能认知负担量表、抗胆碱能药物量表、抗胆碱能负荷量表、抗胆碱能风险量表、更新的临床医生评定的抗胆碱能量表、德国抗胆碱能负担量表和韩国抗胆碱能负担量表。瑞典国家卫生福利委员会提供的具有显著抗胆碱能作用的药物清单也包含在该过程中。建议的 Swe-ABS 由 104 种药物组成，这些药物被评为具有弱、中或强抗胆碱能作用。根据先前量表的评估，256 种药物被列为无抗胆碱能作用。共有 62 种药物由专家组进行评估。
结论
Swe-ABS 是一种量化抗胆碱能负担的简化方法，易于在临床实践中使用。该量表的发布可能会使临床医生更加关注具有抗胆碱能特性的药物和患者的总抗胆碱能负担。需要进一步研究来验证 Swe-ABS，并评估抗胆碱能暴露与临床相关结局之间的关系。
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