title: Prevalence of Anticholinergic Medication Use in the Program of All-Inclusive Care for the Elderly.
abstract: OBJECTIVE
  Evaluate the prevalence of anticholinergic medication use in the Program of All-Inclusive Care for the Elderly (PACE).
  
  
  METHODS
  Cross-sectional, retrospective chart review.
  
  
  METHODS
  The Basics at Jan Werner PACE, Amarillo, Texas.
  
  
  METHODS
  PACE participants (n = 128) and long-term care residents (n = 105) 65 years of age and older.
  
  
  METHODS
  The primary outcome was percentage of prescribed medications with anticholinergic properties and risk factors associated with prescribing: study site, gender, race, age, and creatinine clearance.
  
  
  RESULTS
  Anticholinergic medication prescribing was significantly lower in the PACE program (2.3% of total medications vs. 3.9%; P < 0.05) as well as total medication use (12.1 medications per subject vs. 20.8; P < 0.05 in the long-term care environment). Only the long-term care study site had a significant association with anticholinergic prescribing (odds ratio = 5.04, confidence interval 2.71-9.38). PACE participants also had lower Anticholinergic Risk Scale scores (score of 0, 60.2% PACE vs. 16.2%), reduced fall rates (23.8 per month PACE vs. 66.9), and similar hospitalization rates (5.4 per month PACE vs. 5.7).
  
  
  CONCLUSIONS
  PACE participants were prescribed fewer medications and had lower anticholinergic burden, which potentially lowers their risk of adverse effects. These data support the PACE interdisciplinary model by demonstrating the benefit of team care in appropriate use of medications. It provides a potential blueprint to organizations aimed at reducing potentially inappropriate medication prescribing in older adults.
authors.affiliation: Texas Tech University Health Sciences Center (TTUHSC) School of Pharmacy, Amarillo, Texas, USA.
authors.forename: Les P
authors.initials: LP
authors.lastname: Covington
authors.forename: Jamie
authors.initials: J
authors.lastname: McCarrell
authors.forename: Nicole S
authors.initials: NS
authors.lastname: Hoerster
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D018680:Cholinergic Antagonists / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D003430:Cross-Sectional Studies; D005260:Female; D006299:Health Services for the Aged / Q000706:statistics & numerical data*; D006801:Humans; D057970:Inappropriate Prescribing / Q000517:prevention & control; D008134:Long-Term Care / Q000706:statistics & numerical data*; D008297:Male; D010348:Patient Care Team / Q000458:organization & administration; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D013781:Texas
chemical_list: D018680:Cholinergic Antagonists