Evidence map›Paper›PMID 26350641›Full record

ReviewEuropean journal of clinical pharmacology2015

Different methods, different results--how do available methods link a patient's anticholinergic load with adverse outcomes?

Tanja Mayer, Walter E Haefeli, Hanna M Seidling

Abstract readReview
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In one paragraph

Review in European journal of clinical pharmacology, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 32 papers, 6 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
32citing papers in PubMed, 6 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

32 citing papers in PubMed, 6 syntheses or guidelines pooled it.

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  10. A simulation study comparing anticholinergic drug use with polypharmacy for risk of death, dementia, and delirium in UK Biobank.The journals of gerontology. Series A, Biological sciences and medical sciences · 2025
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors.

Tanja MayerDepartment of Clinical Pharmacology and Pharmacoepidemiology, University of Heidelberg, Im Neuenheimer Feld 410, 69120, Heidelberg, Germany.
Walter E HaefeliDepartment of Clinical Pharmacology and Pharmacoepidemiology, University of Heidelberg, Im Neuenheimer Feld 410, 69120, Heidelberg, Germany.
Hanna M SeidlingDepartment of Clinical Pharmacology and Pharmacoepidemiology, University of Heidelberg, Im Neuenheimer Feld 410, 69120, Heidelberg, Germany. hanna.seidling@med.uni-heidelberg.de.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeAnticholinergic drugs are known to cause physical and cognitive impairment, particularly in older patients. The total of all anticholinergic influences to which a patient is exposed is referred to as anticholinergic load. Because the anticholinergic load is defined in various ways, this review aimed to describe differences in the development and evaluation of available methods calculating the anticholinergic load.

methodsFrom September 2014 to August 2015, two reviewers performed a literature search in PubMed considering relevant items of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline. We aimed to identify articles which calculated the anticholinergic load with a scale or equation and investigated its association with patient-related outcomes. From the included studies, we descriptively analyzed the identification and scoring criteria of the scales and equations with a main emphasis on their association to the reported outcomes.

resultsOut of 465 articles, 55 were included referring to 12 scales and one equation. Main discrepancies were located in eight different identification criteria for anticholinergic drugs, two different scoring principles, and 118 tests used for assessing outcomes. The methods most frequently detecting a significant association between the anticholinergic load and outcomes took into account the drugs' dosages and anticholinergic potencies. Interestingly, none of the methods included the patient's susceptibility for anticholinergic effects and they only rarely considered modulators of drug exposure.

conclusionsDue to hugely varying tests for assessing outcomes, the methods are scarcely comparable. For a more valuable comparison, the anticholinergic load should be calculated with all scales and the equation and correlated with patient-related outcomes.

Indexed as

Cholinergic AntagonistsCognition DisordersHumansCholinergic AntagonistsAdverse drug reactionsAnticholinergic drugsDrug Burden Index

Identifiers

PMID26350641

What OpenQuestion holds

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Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.