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Anticholinergic burden risk and prevalence of medications carrying anticholinergic properties in elderly cancer patients in Jordan

BACKGROUND: Geriatric cancer patients are susceptible to adverse drug events due to the complexity of their chemotherapy regimens and collateral treatments for their comorbid conditions. Prescribing medications with anticholinergic burden characteristics can complicate their condition, leading to ne...

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Autores principales: Al-Azayzih, Ahmad, Jarab, Anan S., Bani-Ahmad, Enas, Smadi, Saja, Kharaba, Zelal, Al-Kubaisi, Khalid A.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10406854/
https://www.ncbi.nlm.nih.gov/pubmed/37559866
http://dx.doi.org/10.1016/j.jsps.2023.101710
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author Al-Azayzih, Ahmad
Jarab, Anan S.
Bani-Ahmad, Enas
Smadi, Saja
Kharaba, Zelal
Al-Kubaisi, Khalid A.
author_facet Al-Azayzih, Ahmad
Jarab, Anan S.
Bani-Ahmad, Enas
Smadi, Saja
Kharaba, Zelal
Al-Kubaisi, Khalid A.
author_sort Al-Azayzih, Ahmad
collection PubMed
description BACKGROUND: Geriatric cancer patients are susceptible to adverse drug events due to the complexity of their chemotherapy regimens and collateral treatments for their comorbid conditions. Prescribing medications with anticholinergic burden characteristics can complicate their condition, leading to negative impacts on their health outcomes and quality of life, including an increase in adverse drug event frequency, physical and cognitive impairments. OBJECTIVE: This study aims to examine the prevalence of anticholinergic prescribing and identify the cumulative anticholinergic load risk associated with drugs prescribed to elderly cancer patients. Also, to identify the predictors that might lead to raised anticholinergic burden in these patients. METHODOLOGY: This retrospective cross-sectional study included elderly patients (age ≥ 65) diagnosed with cancer and admitted to the adult oncology unit at King Abdullah University Hospital (KAUH) in Jordan during the period between (January 1st, 2019, and January 1st, 2022). The medication charts of 420 patients were evaluated for study outcomes. RESULTS: Of the total subjects, females represented 49.3%, and the average age was 72.95 (SD = 7.33). A total of 354 (84.3%) patients were prescribed at least one drug carrying anticholinergic burden properties. Median for anticholinergic medications was 3 (IQR = 4). Our study found that 194 (46.2%) patients were at a high risk of adverse events associated with anticholinergic load (cumulative score ≥ 3). Metoclopramide, furosemide, and tramadol were the most frequently prescribed drugs with anticholinergic properties. Alimentary tract drugs with anticholinergic action were the most commonly encountered items in our study population. CONCLUSION: Our study revealed a significantly high prevalence of anticholinergic prescribing among elderly cancer patients. Nearly half of the patients were at high risk of developing serious effects related to anticholinergic activity from the drugs administered. Polypharmacy was strongly associated with increased anticholinergic burden score. Evidence-based recommendations utilizing prescribing strategies for safer alternatives and deprescribing of inappropriate medications could reduce such inappropriate prescribing.
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spelling pubmed-104068542023-08-09 Anticholinergic burden risk and prevalence of medications carrying anticholinergic properties in elderly cancer patients in Jordan Al-Azayzih, Ahmad Jarab, Anan S. Bani-Ahmad, Enas Smadi, Saja Kharaba, Zelal Al-Kubaisi, Khalid A. Saudi Pharm J Original Article BACKGROUND: Geriatric cancer patients are susceptible to adverse drug events due to the complexity of their chemotherapy regimens and collateral treatments for their comorbid conditions. Prescribing medications with anticholinergic burden characteristics can complicate their condition, leading to negative impacts on their health outcomes and quality of life, including an increase in adverse drug event frequency, physical and cognitive impairments. OBJECTIVE: This study aims to examine the prevalence of anticholinergic prescribing and identify the cumulative anticholinergic load risk associated with drugs prescribed to elderly cancer patients. Also, to identify the predictors that might lead to raised anticholinergic burden in these patients. METHODOLOGY: This retrospective cross-sectional study included elderly patients (age ≥ 65) diagnosed with cancer and admitted to the adult oncology unit at King Abdullah University Hospital (KAUH) in Jordan during the period between (January 1st, 2019, and January 1st, 2022). The medication charts of 420 patients were evaluated for study outcomes. RESULTS: Of the total subjects, females represented 49.3%, and the average age was 72.95 (SD = 7.33). A total of 354 (84.3%) patients were prescribed at least one drug carrying anticholinergic burden properties. Median for anticholinergic medications was 3 (IQR = 4). Our study found that 194 (46.2%) patients were at a high risk of adverse events associated with anticholinergic load (cumulative score ≥ 3). Metoclopramide, furosemide, and tramadol were the most frequently prescribed drugs with anticholinergic properties. Alimentary tract drugs with anticholinergic action were the most commonly encountered items in our study population. CONCLUSION: Our study revealed a significantly high prevalence of anticholinergic prescribing among elderly cancer patients. Nearly half of the patients were at high risk of developing serious effects related to anticholinergic activity from the drugs administered. Polypharmacy was strongly associated with increased anticholinergic burden score. Evidence-based recommendations utilizing prescribing strategies for safer alternatives and deprescribing of inappropriate medications could reduce such inappropriate prescribing. Elsevier 2023-09 2023-07-26 /pmc/articles/PMC10406854/ /pubmed/37559866 http://dx.doi.org/10.1016/j.jsps.2023.101710 Text en © 2023 The Author(s) https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Original Article
Al-Azayzih, Ahmad
Jarab, Anan S.
Bani-Ahmad, Enas
Smadi, Saja
Kharaba, Zelal
Al-Kubaisi, Khalid A.
Anticholinergic burden risk and prevalence of medications carrying anticholinergic properties in elderly cancer patients in Jordan
title Anticholinergic burden risk and prevalence of medications carrying anticholinergic properties in elderly cancer patients in Jordan
title_full Anticholinergic burden risk and prevalence of medications carrying anticholinergic properties in elderly cancer patients in Jordan
title_fullStr Anticholinergic burden risk and prevalence of medications carrying anticholinergic properties in elderly cancer patients in Jordan
title_full_unstemmed Anticholinergic burden risk and prevalence of medications carrying anticholinergic properties in elderly cancer patients in Jordan
title_short Anticholinergic burden risk and prevalence of medications carrying anticholinergic properties in elderly cancer patients in Jordan
title_sort anticholinergic burden risk and prevalence of medications carrying anticholinergic properties in elderly cancer patients in jordan
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10406854/
https://www.ncbi.nlm.nih.gov/pubmed/37559866
http://dx.doi.org/10.1016/j.jsps.2023.101710
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