Tom Vermeulen, Anne-Marie Borghs, Annelies Pieters, Steven Dirickx, Jo Sels, Kris Van den Broeck
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引用次数: 0
摘要
老年人更容易受到药物副作用的影响。主要的抗胆碱能副作用可导致躯体和认知水平的中枢性和外周性副作用。在本研究中,我们使用两种有效的测量量表来测定住院护理中心居民用药方案的抗胆碱能负荷。我们还研究了药物种类在多大程度上影响这种抗胆碱能负荷。最后,我们分析了高抗胆碱能负荷与事件(尿路感染、跌倒、谵妄)的关系。在这项初步研究中,我们看到了高度的多重用药和使用具有抗胆碱能作用的精神药物。我们建立的ACB平均得分为1.67,DBI平均得分为0.87。ACB的抗胆碱能负荷主要受抗精神病药物影响(β = 0.647, p < 0.001), DBI的抗胆碱能负荷主要受所有药物的影响,包括总抗胆碱能负荷和镇静负荷(F = 6.764, p < 0.001)。DBI风险评分与尿路感染有统计学意义的相关性(F = 5.877, p = 0.018)。在调整协变量后,这种影响仍然显著。居民用药方案的抗胆碱能负荷较高。抗胆碱能负荷增加也与尿路感染有关。因此,减少住院护理中心的抗胆碱能负荷是未来的一个重要挑战。
[Anticholinergic burden in older adults in a residential care center: a pilot study].
Older adults are more at risk for side effects from medications. Mainly anticholinergic side effects can lead to central and peripheral side effects on somatic and cognitive levels. In this study, we determined the anticholinergic load of the medication regimens of residents of a residential care centre using two validated measurement scales. We also examined to which extent the class(es) of medications influence this anticholinergic load. Finally, we analysed the association of a high anticholinergic load with incidents (urinary tract infections, falls, delirium).In this pilot study, we see a high degree of polymedication and use of psychotropic drugs with an anticholinergic effect. On average, we established a score of 1.67 on the ACB and a score of 0.87 on the DBI. The anticholinergic load in the ACB is mainly determined by antipsychotics (β = 0,647, p ‹ 0.001), in the DBI an influence of all medications with total anticholinergic and sedative load (F = 6.764, p ‹ 0.001). A risk score on the DBI has a statistically significant correlation with experiencing a urinary tract infection (F = 5.877, p = 0.018). This influence remains significant after adjusting for covariates.The anticholinergic load of medication regimens in residents is high. An increased anticholinergic load is also associated with urinary tract infection. Reducing the anticholinergic load within residential care centres therefore represents an important challenge for the future.