title: Drug Burden Index in older adults: theoretical and practical issues.
abstract: Anticholinergic and sedative medications are commonly used in older adults and are associated with adverse clinical outcomes. The Drug Burden Index was developed to measure the cumulative exposure to these medications in older adults and its impact on physical and cognitive function. This narrative review discusses the research and clinical applications of the Drug Burden Index, and its advantages and limitations, compared with other pharmacologically developed measures of high-risk prescribing.
authors.affiliation: Sydney Medical School, University of Sydney, Kolling Institute of Medical Research and Departments of Clinical Pharmacology and Aged Care, Royal North Shore Hospital, NSW, Australia.
authors.forename: Lisa
authors.initials: L
authors.lastname: Kouladjian
authors.affiliation: Sydney Medical School, University of Sydney, Kolling Institute of Medical Research and Departments of Clinical Pharmacology and Aged Care, Royal North Shore Hospital, NSW, Australia ; Faculty of Pharmacy, University of Sydney, Sydney, NSW, Australia.
authors.forename: Danijela
authors.initials: D
authors.lastname: Gnjidic
authors.affiliation: Faculty of Pharmacy, University of Sydney, Sydney, NSW, Australia.
authors.forename: Timothy F
authors.initials: TF
authors.lastname: Chen
authors.affiliation: Department of Clinical Pharmacology, School of Medicine, Flinders University and Flinders Medical Centre, Bedford Park, SA, Australia.
authors.forename: Arduino A
authors.initials: AA
authors.lastname: Mangoni
authors.affiliation: Sydney Medical School, University of Sydney, Kolling Institute of Medical Research and Departments of Clinical Pharmacology and Aged Care, Royal North Shore Hospital, NSW, Australia.
authors.forename: Sarah N
authors.initials: SN
authors.lastname: Hilmer
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D018680:Cholinergic Antagonists / Q000009:adverse effects*; D003071:Cognition / Q000187:drug effects*; D006801:Humans; D006993:Hypnotics and Sedatives / Q000009:adverse effects*; D057970:Inappropriate Prescribing; D009068:Movement / Q000187:drug effects*; D019338:Polypharmacy
chemical_list: D018680:Cholinergic Antagonists; D006993:Hypnotics and Sedatives
keywords: Drug Burden Index; anticholinergics; deprescribing; high-risk prescribing; older adults; pharmacological risk assessment tools; sedative medications