Srikartika Valentina M, Ha Ninh, Youens David, Moorin Rachael
Health Economics and Data Analytics, School of Population Health, Curtin University, Perth, Western Australia 6102, Australia; Pharmacy Program Study, Faculty of Mathematics and Natural Science, Lambung Mangkurat University, Banjarbaru, South Kalimantan 70714, Indonesia.
Health Economics and Data Analytics, School of Population Health, Curtin University, Perth, Western Australia 6102, Australia.
Arch Gerontol Geriatr. 2025 Feb;129:105646. doi: 10.1016/j.archger.2024.105646. Epub 2024 Sep 30.
This systematic review aimed to identify and evaluate the quality and adaptability of existing anticholinergic burden scales and measures by using administrative dispensing data.
A comprehensive literature search was conducted using the Medline, Embase, CINAHL, and Google Scholar databases from 2001 to 2022. Studies that introduced, updated, or modified anticholinergic burden scales and measures were included in this review. Quality assessment considered various aspects, including scoring systems, tool development criteria, and specific requirements tailored for administrative data.
Twenty-eight anticholinergic burden scales and measures were identified in 14 countries. The Modified Anticholinergic Risk Scale excelled in the scoring system, while the German Anticholinergic Burden Scale stood out in the scale development process. However, significant variability was observed in methodologies, medication listings, and adaptability to administrative data. Quality assessment considers aspects such as potency, dose, exposure duration, longitudinal measurement, clinical interpretation, and compatibility with administrative data variables. The evaluation also considered tool development criteria including evidence for medication selection, panel expertise, relevance, updating methods, international applicability, validation, and clinical guidance.
This review emphasizes the importance of adaptable and robust tools that can work well with administrative data to ensure patient safety and better health outcomes, given the ongoing evolution of anticholinergic medications. The findings of this systematic review provide valuable insights for clinicians and researchers in selecting the most appropriate anticholinergic burden scale or measure according to their specific needs and data sources. This systematic review was registered with PROSPERO (registration ID CRD42023423959).
本系统评价旨在通过使用行政配药数据来识别和评估现有抗胆碱能负担量表及测量方法的质量和适用性。
使用Medline、Embase、CINAHL和谷歌学术数据库对2001年至2022年的文献进行全面检索。纳入本评价的研究包括介绍、更新或修改抗胆碱能负担量表及测量方法的研究。质量评估考虑了多个方面，包括评分系统、工具开发标准以及针对行政数据的特定要求。
在14个国家识别出了28种抗胆碱能负担量表及测量方法。改良抗胆碱能风险量表在评分系统方面表现出色，而德国抗胆碱能负担量表在量表开发过程中脱颖而出。然而，在方法、药物清单以及对行政数据的适用性方面观察到了显著差异。质量评估考虑了效力、剂量、暴露持续时间、纵向测量、临床解释以及与行政数据变量的兼容性等方面。评价还考虑了工具开发标准，包括药物选择的证据、专家小组的专业知识、相关性、更新方法、国际适用性、验证以及临床指导。
鉴于抗胆碱能药物的不断发展，本评价强调了能够与行政数据良好配合以确保患者安全和更好健康结果的适应性强且稳健的工具的重要性。本系统评价的结果为临床医生和研究人员根据其特定需求和数据源选择最合适的抗胆碱能负担量表或测量方法提供了有价值的见解。本系统评价已在PROSPERO注册（注册号CRD42023423959）。
