Evidence map›Paper›PMID 27909739›Full record

SynthesisEuropean journal of clinical pharmacology2017

Quantification of anticholinergic and sedative drug load with the Drug Burden Index: a review of outcomes and methodological quality of studies.

Hans Wouters, Helene van der Meer, Katja Taxis

Abstract readSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in European journal of clinical pharmacology, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 47 papers.

0numbers the graph read from it
0cells of the map it votes in
47citing papers in PubMed
–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

47 citing papers in PubMed.

  1. Trial
  2. Trial
  3. Trial
  4. Frailty, polypharmacy, deprescribing, and 23-hour activity: insights from a mouse model.The journals of gerontology. Series A, Biological sciences and medical sciences · 2026
    Article
  5. Article
  6. Article
  7. Article
  8. Article
  9. Observational
  10. Article
  11. Article
  12. Article
  13. Observational
  14. Article
  15. Article
  16. Article
  17. Evaluation of anticholinergic burden in elderly outpatients and the risk factors.Zhong nan da xue xue bao. Yi xue ban = Journal of Central South University. Medical sciences · 2023
    Article
  18. Article
  19. Review
  20. Applying the AFRAID and FRIGHT Clocks to Novel Preclinical Mouse Models of Polypharmacy.The journals of gerontology. Series A, Biological sciences and medical sciences · 2022
    Article
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.

Hans WoutersDepartment of PharmacoTherapy, -Epidemiology & -Economics [PTEE], Groningen Research Institute of Pharmacy, Faculty of Mathematics and Natural Sciences, University of Groningen, Antonius Deusinglaan 1, 9713 AV, Groningen, Netherlands. h.wouters@rug.nl.
Helene van der MeerDepartment of PharmacoTherapy, -Epidemiology & -Economics [PTEE], Groningen Research Institute of Pharmacy, Faculty of Mathematics and Natural Sciences, University of Groningen, Antonius Deusinglaan 1, 9713 AV, Groningen, Netherlands.
Katja TaxisDepartment of PharmacoTherapy, -Epidemiology & -Economics [PTEE], Groningen Research Institute of Pharmacy, Faculty of Mathematics and Natural Sciences, University of Groningen, Antonius Deusinglaan 1, 9713 AV, Groningen, Netherlands.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThe Drug Burden Index (DBI) is a non-invasive method to quantify patients' anticholinergic and sedative drug burden from their prescriptions. This systematic review aimed to summarise the evidence on the associations between the DBI and clinical outcomes and methodological quality of studies.

methodsA search in PubMed and Embase (search terms: 'drug', 'burden', and 'index') was performed and experts were contacted. We excluded publications that did not report empirical results or clinical outcomes. Methodological quality was assessed using the Newcastle-Ottawa Scale. Potential omissions of relevant clinical outcomes and populations were studied.

resultsOf the 2998 identified publications, 21 were eligible. Overall, methodological quality of studies was good. In all but one study, adjustment was made for prevalent co-morbidity. The DBI was examined in diverse older individuals, i.e. both males and females from different settings and countries. However, no studies were conducted in other relevant patient groups, e.g. psychiatric patients. Exposure to anticholinergic and sedative drugs was thoroughly ascertained, though the specific calculation of the DBI differed across studies. Outcomes were assessed from medical records, record linkage or validated objective tests or questionnaires. Many studies found associations between the DBI and outcomes including hospitalisation, physical and cognitive function. Cognitive function and quality of life were understudied and the number and scope of longitudinal studies was limited.

conclusionsAn accumulating body of evidence supports the validity of the DBI. Longitudinal studies of cognitive function and quality of life and in other patient groups, e.g. psychiatric patients, are warranted.

Indexed as

AgedCholinergic AntagonistsFemaleHumansHypnotics and SedativesMaleMedical Record LinkagePolypharmacyCholinergic AntagonistsHypnotics and SedativesAntimuscarinic agentsHypnotics and sedativesInappropriate prescribingOlder adults, frailtyPolypharmacy

Identifiers

PMID27909739
PMCPMC5306241

What OpenQuestion holds

Textmetadata
LicenceCC BY
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.