title: Audit of anticholinergic medication changes in older hospitalised patients using the Anticholinergic Drug Scale.
abstract: OBJECTIVE
  In patients discharged from an Older Person's Health hospital, we assessed (i) the prevalence of anticholinergic medications (ACM) in this study population and (ii) changes in anticholinergic drug burden during admission using the Anticholinergic Drug Scale (ADS).
  
  
  METHODS
  Cases were identified between September 2010 and January 2011 using discharge coding data. Clinical notes were reviewed to determine which regular oral medications were commenced, altered or ceased during admission with their respective ADS level. The anticholinergic drug burden was measured using the total ADS score for each patient on presentation and at discharge. The difference in these two values was defined as the overall change in ADS.
  
  
  RESULTS
  There was a total of 224 cases. Median age was 83 years (interquartile range 78-87). Median total number of medications per patient on both admission and discharge was 6. Most (168/224, 75%) patients were discharged on ACM, including 25% (56/224) with a high total ADS score. The medications most commonly commenced and ceased were laxatives and diuretics respectively. These medications had ADS level 0-1. There was no significant change in ADS score between admission and discharge (P = 0.50).
  
  
  CONCLUSIONS
  The total number of medications prescribed and the overall anticholinergic drug burden did not change significantly despite geriatric assessment.
authors.affiliation: General Medicine Department, Canterbury District Health Board, Christchurch, New Zealand.
authors.forename: Michele S S
authors.initials: MSS
authors.lastname: Lee
authors.affiliation: Older Person's Health Specialist Service, Canterbury District Health Board, Christchurch, New Zealand.
authors.forename: Hugh C
authors.initials: HC
authors.lastname: Hanger
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D018680:Cholinergic Antagonists / Q000627:therapeutic use*; D017723:Drug Utilization Review / Q000379:methods*; D005260:Female; D015577:Geriatric Assessment / Q000379:methods*; D006760:Hospitalization / Q000639:trends; D006801:Humans; D008297:Male; D008485:Medical Audit / Q000379:methods*; D008875:Middle Aged
chemical_list: D018680:Cholinergic Antagonists
keywords: adverse drug reaction; anticholinergics; elderly; inappropriate prescribing; polypharmacy