Korean J Clin Pharm.  2020 Jun;30(2):113-119. 10.24304/kjcp.2020.30.2.113.

Impacts of Pharmacist-involved Multidisciplinary Geriatric Team Services on Reducing Anticholinergic Burden

• Lee J
• Park K
• Suh Y
• Lee J
• Lee E
• Lee E
• Choi JY
• Kim KI
• Lee JY

• KMID: 2503879
• DOI: http://doi.org/10.24304/kjcp.2020.30.2.113

Abstract

Background
Reducing the total anticholinergic burden (AB) in older adults is recommended owing to the several peripheral and central adverse effects. This study aimed to identify the AB status of patients admitted to geriatric centers for assessing the influence of the pharmacist-involved multidisciplinary geriatric team care on reducing the AB.
Methods
We retrospectively reviewed the medical records of 328 older patients hospitalized in geriatric centers from July 1, 2018 to June 30, 2019, who received comprehensive geriatric assessment and pharmaceutical interventions from a multidisciplinary geriatric team. We measured the total AB scores for the medications at the time of admission and upon hospital discharge using the Korean Anticholinergic Burden Scale (KABS). The pre-admission factors associated with high AB (KABS score ≥3) at the time of admission were identified.
Results
The proportion of patients with high AB significantly decreased from 41.8% (136/328) at the time of admission to 25.0% (82/328) on discharge (p<0.001). The pre-admission AB of patients transferred from skilled nursing facilities (odds ratio[OR]: 2.85, 95% CI: 1.26- 3.75), taking more than 10 medications (OR: 3.70, 95% CI: 1.55-8.82), suffering from delirium (OR: 2.80, 95% CI: 1.04-7.50), or depression (OR: 2.78, 95% CI: 1.04-7.41) were significantly high. Antipsychotics were the most frequent classes of drugs that contributed to the total KABS score at the time of admission, followed by antihistamines.
Conclusions
This study demonstrated that the multidisciplinary teams for geriatric care are effective at reducing AB in older adults. The factors associated with high AB should be considered when targeting pharmaceutical care in geriatric individuals.

Keyword

Anticholinergic burden; multidisciplinary care; comprehensive geriatric assessment; patient safety