Evidence map›Paper›PMID 29133497›Full record

ArticleAnnals of family medicine2017

Comparative Associations Between Measures of Anti-cholinergic Burden and Adverse Clinical Outcomes.

Wen-Han Hsu, Yu-Wen Wen, Liang-Kung Chen, Fei-Yuan Hsiao

Open access · diamondAbstract readComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Annals of family medicine, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 32 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
32citing papers in PubMed, 5 pooled it
3.9field-weighted citation impact, top 7% of its field
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, 5 syntheses or guidelines pooled it, 79 citations in OpenAlex.

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  19. Anticholinergic load and delirium in end-of-life patients.European journal of clinical pharmacology · 2021
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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

4 authors at 4 institutions in 1 country.

Wen-Han HsuGraduate Institute of Clinical Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan.
Yu-Wen WenClinical Informatics and Medical Statistics Research Center, Chang Gung University, Taoyuan City, Taiwan.
Liang-Kung ChenAging and Health Research Center, National Yang-Ming University, Taipei, Taiwan.
Fei-Yuan HsiaoGraduate Institute of Clinical Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan fyshsiao@ntu.edu.tw.
Chang Gung University · TWNational Taiwan University · TWNational Taiwan University Hospital · TWTaipei Veterans General Hospital · TW

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeNo consensus has been reached regarding which anticholinergic scoring system works most effectively in clinical settings. The aim of this population-based cohort study was to examine the association between anticholinergic medication burden, as defined by different scales, and adverse clinical outcomes among older adults.

methodsFrom Taiwan's Longitudinal Health Insurance Database, we retrieved data on monthly anticholinergic drug use measured by the Anticholinergic Risk Scale (ARS), the Anticholinergic Cognitive Burden Scale (ACB), and the Drug Burden Index - Anticholinergic component (DBI-Ach) for 116,043 people aged 65 years and older during a 10-year follow-up. For all 3 scales, a higher score indicates greater anticholinergic burden. We used generalized estimating equations to examine the association between anticholinergic burden (ARS and ACB: grouped from 0 to ≥4; DBI-Ach: grouped as 0, 0-0.5, and 0.5-1) and adverse outcomes, and stratified individuals by age-group (aged 65-74, 75-84, and ≥85 years).

resultsCompared with the ARS and DBI-Ach, the ACB showed the strongest, most consistent dose-response relationships with risks of all 4 adverse outcomes, particularly in people aged 65 to 84 years. For example, among those 65 to 74 years old, going from an ACB score of 1 to a score of 4 or greater, individuals' adjusted odds ratio increased from 1.41 to 2.25 for emergency department visits; from 1.32 to 1.92 for all-cause hospitalizations; from 1.10 to 1.71 for fracture-specific hospitalizations; and from 3.13 to 10.01 for incident dementia.

conclusionsCompared with the 2 other scales studied, the ACB shows good dose-response relationships between anticholinergic burden and a variety of adverse outcomes in older adults. For primary care and geriatrics clinicians, the ACB may be a helpful tool for identifying high-risk populations for interventions.

Indexed as

AgedAged, 80 and overCholinergic AntagonistsCognitionCohort StudiesComorbidityEmergency Service, HospitalFemaleHospitalizationHumansInappropriate PrescribingMaleRisk FactorsTaiwanCholinergic Antagonistsadverse effectsagedanticholinergic burdenAnticholinergic Cognitive Burden scale (ACB)Anticholinergic Risk Scale (ARS)dementiaDrug Burden Index - Anticholinergic component (DBI-Ach)emergency department visitsfractureshospitalizationsolder adultsprimary care

Identifiers

PMID29133497
PMCPMC5683870
OpenAlexW2769514951

What OpenQuestion holds

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Registered trials

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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.