ArticleBMJ open2018
Anticholinergic and sedative drug burden in community-dwelling older people: a national database study.
Article in BMJ open, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 38 papers, 2 of them syntheses that pooled it.
What it found
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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.
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.
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Who cites it
38 citing papers in PubMed, 2 syntheses or guidelines pooled it, 70 citations in OpenAlex.
- Prevalence and factors associated with anticholinergic medication use in community-dwelling older adults: a systematic review.International journal of clinical pharmacy · 2025Pooled it
- Quantifying Anticholinergic Burden and Sedative Load in Older Adults with Polypharmacy: A Systematic Review of Risk Scales and Models.Drugs & aging · 2021Pooled it
- Application of a person-centered prescription model improves pharmacotherapeutic indicators and reduces costs associated with pharmacological treatment in hospitalized older patients at the end of life.Frontiers in public health · 2022Trial
- Differences in Anticholinergic Exposure Assessment Across Burden Scales and Exposure Measures in a Population-Based Study: Implications for Targeted Deprescribing in Older Adults.Drugs & aging · 2026Article
- Comparative predictive performance of anticholinergic burden scales for anticholinergic-related hospitalisation and emergency department visits in older adults: a population-based study of model development and temporal validation.International journal of clinical pharmacy · 2026Article
- Association between anticholinergic and sedative medications and physical functioning: data from the Canadian longitudinal study on aging (CLSA).European journal of clinical pharmacology · 2026Article
- Association Between Anticholinergic Burden and Dry Mouth Severity in Acutely Ill Older Adults.Drugs & aging · 2026Article
- Oral health in people with schizophrenia: associations with behavioural and pharmacological factors.Epidemiology and psychiatric sciences · 2026Article
- Identifying Predictors and Measuring Variation in Anticholinergic Burden and Sedative Load for Older Adult Care Home Residents: A Retrospective Cohort Study Using Routinely Collected Data.Pragmatic and observational research · 2026Article
- Anticholinergic and sedative medications use among community dwelling older adults: risk for polypharmacy and poor physical function.BMC geriatrics · 2025Article
- Tools for Detecting Ageing in People with Autism Spectrum Disorder: A Scoping Review.Healthcare (Basel, Switzerland) · 2025Review
- Anticholinergic and Sedative Medication Burden in Croatian Older Adults: EuroAgeism Cohort Findings.Pharmacy (Basel, Switzerland) · 2025Article
- Observational
- Preadmission medications and recent falls in older inpatients: an observational study.International journal of clinical pharmacy · 2025Observational
- [Study of anticholinergic burden in chronic treatments of outpatients in the Community Pharmacy].Farmaceuticos comunitarios · 2025Observational
- Racial, Ethnic, and Age-Related Disparities in Sedation and Restraint Use for Older Adults in the Emergency Department.The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry · 2025Article
- A comparison of changes in drug burden index between older inpatients who fell and people who have not fallen: A case-control study.Australasian journal on ageing · 2024Observational
- Anticholinergic Burden and Dry Mouth Problems Among Older Adults (≥ 50 Years) Receiving Dental Care-A Retrospective, Cross-Sectional Analysis.Clinical and experimental dental research · 2024Article
- Carers' experiences and perspectives of the use of anticholinergic medications in people living with dementia: Analysis of an online discussion forum.Health expectations : an international journal of public participation in health care and health policy · 2024Article
- Potentially Inappropriate Prescribing and Potential Prescribing Omissions and Their Association with Adverse Drug Reaction-Related Hospital Admissions.Journal of clinical medicine · 2024Article
Corrections and comments
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Authors and funding
6 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesThe Drug Burden Index (DBI) tool quantifies individual exposure to anticholinergic and sedative medications. The DBI has been internationally validated against adverse health outcomes in older people. DBI exposure has not been reported in the Irish older population. This study aimed to: (1) develop a list of drugs with clinically significant anticholinergic and/or sedative effects (DBI medications) relevant to Ireland; (2) examine, using the DBI formula, the prevalence of exposure to DBI medications in Irish older people and (3) explore patient factors associated DBI exposure.
designA cross-sectional national pharmacy claims database study.
settingCommunity setting using the General Medical Services (GMS) scheme pharmacy claims database maintained by the Health Service Executive Primary Care Reimbursement Services.
participantsIrish older individuals (aged ≥65 years) enrolled in the GMS scheme and dispensed at least one prescription item in 2016 (n=428 516).
main outcome measuresPrevalence of exposure to DBI medications and patient factors associated with DBI exposure.
results282 874 (66%) of the GMS population aged ≥65 years were exposed to at least one DBI medication in 2016. Prevalence of exposure to DBI medications was significantly higher in females than males (females 71.6% vs males 58.7%, adjusted OR 1.65, 95% CI 1.63 to 1.68). Prevalence of DBI exposure increased progressively with the number of chronic drugs used, rising from 42.7% of those prescribed 0-4 chronic drugs to 95.4% of those on ≥12 chronic drugs (adjusted OR 27.8, 95% CI 26.7 to 29.0). The most frequently used DBI medications were codeine/paracetamol combination products (20.1% of patients), tramadol (11.5%), zopiclone (9.5%), zolpidem (8.5%), pregabalin (7.9%) and alprazolam (7.8%).
conclusionsThe majority of older people in Ireland are exposed to medications with anticholinergic and/or sedative effects, particularly females and those with multiple comorbidities. The high use of low-dose codeine/paracetamol combination products, Z-drugs and benzodiazepines, suggests there are opportunities for deprescribing.
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