Anticholinergic Risk and Frequency of Anticholinergic Drug Prescriptions in a Population Older Than 65

Abstract

Objective: To determine the risk and frequency of anticholinergic drug prescriptions in a population affiliated with the Colombian General System of Social Security in Health.

Design: A cross-sectional study was conducted in 2013.

Participants: Patients older than 65 years who received drugs with the potential to block cholinergic receptors, in accordance with an anticholinergic risk scale.

Measurements: The total anticholinergic load was determined by the sum of the risk of each prescribed drug.

Results: The study included a total of 27,654 patients with a mean age of 76.1 ± 7.6 years, and 61.9% were women. A total of 9.1% of the population older than 65 years had received a prescription of at least one of these drugs, and the prevalence of these prescriptions was 112.5 per 1000 members. The average number of drugs prescribed per patient was 1.4, and the drugs most frequently prescribed contained trazodone, methocarbamol, and loratadine. Being prescribed by practitioners of surgical or related specialties was the only variable significantly associated with prescriptions with high anticholinergic risk in the multivariate analysis (odds ratio 1.61; 95% confidence interval 1.335-1.934; P < .001).

Conclusion: We found a high frequency of prescription medications with some degree of anticholinergic load, and in almost half of the patients, the anticholinergic risk score was very high. The prevalence of prescription of these drugs falls in the range of that reported globally. It is essential to educate prescribers about the risk to their patients.

Keywords: Cholinergic antagonists; aged 80 and older; health services; pharmacoepidemiology (MeSH); prescription drugs.