Evidence map›Paper›PMID 36203156›Full record

ArticleBMC geriatrics2022

Anti-cholinergic drug burden in patients with dementia increases after hospital admission: a multicentre cross-sectional study.

Annabelle Hook, Jessica L Randall, Carla M Grubb, Natalie Ellis, Jack Wellington, Aayushi Hemmad, Agisilaos Zerdelis, Andrew R D Winnett, Benjamin D W Geers, Bethany Sykes and 20 more

Open access · goldAbstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC geriatrics, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed, 1 pooled it
1.0field-weighted citation impact, top 26% 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

8 citing papers in PubMed, 1 synthesis or guideline pooled it, 8 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Article
  4. Article
  5. Observational
  6. Article
  7. Article
  8. Impact of Hospitalizations on Problematic Medication Use Among Community-Dwelling Persons With Dementia.The journals of gerontology. Series A, Biological sciences and medical sciences · 2024
    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

30 authors at 20 institutions in 1 country.

Annabelle Hook *Cardiff University School of Medicine, Neuadd Meirionnydd, Cardiff, CF14 4YS, UK. annabelle.hook@nhs.net.
Jessica L Randall *Cardiff University School of Medicine, Neuadd Meirionnydd, Cardiff, CF14 4YS, UK.
Carla M GrubbCardiff University School of Medicine, Neuadd Meirionnydd, Cardiff, CF14 4YS, UK.
Natalie EllisCardiff University School of Medicine, Neuadd Meirionnydd, Cardiff, CF14 4YS, UK.
Jack WellingtonCardiff University School of Medicine, Neuadd Meirionnydd, Cardiff, CF14 4YS, UK.
Aayushi HemmadThe Medical School, Newcastle University, Framlington Place, Newcastle upon Tyne, NE2 4HH, UK.
Agisilaos ZerdelisThe James Cook University Hospital, Marton Road, Middlesbrough, TS4 3BW, UK.
Andrew R D WinnettWhipps Cross University Hospital, Whipps Cross Road, Leytonstone, London, EN11 1NR, UK.
Benjamin D W GeersSchool of Medicine, University of Manchester, Manchester, M13 9PL, UK.
Bethany SykesUniversity of Exeter Medical School, Heavitree Road, Exeter, EX1 2LU, UK.
Charlotte N AutySchool of Medicine, University of Manchester, Manchester, M13 9PL, UK.
Cecilia VinchenzoLancaster Medical School, Faculty of Health and Medicine, Lancaster University, Furness Building, Lancaster, LA1 4YG, UK.
Christiane E ThorburnBristol Medical School, University of Bristol, First Floor, 5 Tyndall Avenue, Bristol, BS8 1UD, UK.
Daniella AsogbonBirmingham Medical School, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK.
Emily GrangerUniversity Hospitals of Morecambe Bay NHS Foundation Trust, Burton Road, Kendal, LA9 7RG, UK.
Heather BoageyMedical Sciences Division, University of Oxford,  John Radcliffe Hospital, Headley Way, Oxford, OX3 9DU, UK.
Juliet RaphaelNorwich Medical School, University of East Anglia, Norwich Research Park, Norwich, Norfolk, NR4 7TJ, UK.
Kajal PatelSchool of Medicine, University of Manchester, Manchester, M13 9PL, UK.
Kartik BhargavaThe Medical School, Newcastle University, Framlington Place, Newcastle upon Tyne, NE2 4HH, UK.
Mary-Kate M DolleyPeninsula Medical School, The Faculty of Medicine and Dentistry, The John Bull Building, Plymouth Science Park, Research Way, Plymouth, PL6 8BU, UK.
Matthew J MadenSchool of Medicine, University of Manchester, Manchester, M13 9PL, UK.
Mehdin M ShahBart's and The London School of Medicine and Dentistry, Queen Mary's University of London, Garrod Building, Turner Street, Whitechapel, London, E1 2AD, UK.
Qao M LeeBart's and The London School of Medicine and Dentistry, Queen Mary's University of London, Garrod Building, Turner Street, Whitechapel, London, E1 2AD, UK.
Ratnaraj VaidyaThe Medical School, Newcastle University, Framlington Place, Newcastle upon Tyne, NE2 4HH, UK.
Simran SehdevFaculty of Medicine, University of Southampton, Building 85, Life Sciences Building, Highfield Campus, Southampton, SO17 1BJ, UK.
Sneha BaraiSchool of Clinical Medicine, University of Cambridge, Box 111, Cambridge Biomedical Campus, Cambridge, CB2 0SP, UK.
Sophie RocheMedical Sciences Division, University of Oxford,  John Radcliffe Hospital, Headley Way, Oxford, OX3 9DU, UK.
Uzair KhalidUniversity College London Medical School, 74 Huntley St, Bloomsbury, London, WC1E 6DE, UK.
David A Codling *King's College London, Institute of Psychiatry, Psychology and Neuroscience, 16 De Crespigny Park, London, SE5 8AF, UK.
Judith R Harrison *Biomedical Research Building Campus for Ageing and Vitality, Newcastle University, Newcastle upon Tyne, NE4 5PL, UK.
Cardiff University · GBUniversity of Manchester · GBNewcastle University · GBQueen Mary University of London · GBHeavitree Hospital · GBJohn Radcliffe Hospital · GBKing's College London · GBLancaster University · GBNewcastle Hospitals - Campus for Ageing and Vitality · GBNorwich Research Park · GBPeninsula College of Medicine and Dentistry · GBPeterborough City Hospital · GBUniversity College London · GBUniversity Hospital of Wales · GBUniversity Hospitals of Morecambe Bay NHS Foundation Trust · GBUniversity of Birmingham · GBUniversity of Bristol · GBUniversity of Oxford · GBUniversity of Southampton · GBWhipps Cross University Hospital · GB

Funding

Wellcome Trust
6 · The paper itself

Abstract

backgroundAnticholinergic medications are drugs that block cholinergic transmission, either as their primary therapeutic action or as a secondary effect. Patients with dementia may be particularly sensitive to the central effects of anticholinergic drugs. Anticholinergics also antagonise the effects of the main dementia treatment, cholinesterase inhibitors. Our study aimed to investigate anticholinergic prescribing for dementia patients in UK acute hospitals before and after admission.

methodsWe included 352 patients with dementia from 17 UK hospital sites in 2019. They were all inpatients on surgical, medical or Care of the Elderly wards. Information about each patient's medications were collected using a standardised form, and the anticholinergic drug burden of each patient was calculated with an evidence-based online calculator. Wilcoxon's rank test was used to look at the correlation between two subgroups upon admission and discharge.

resultsOn admission to hospital, 37.8% of patients had an anticholinergic burden score ≥ 1 and 5.68% ≥3. On discharge, 43.2% of patients with an anticholinergic burden score ≥ 1 and 9.1% ≥3. The increase in scores was statistically significant (p = 0.001). Psychotropics were the most common group of anticholinergic medications prescribed at discharge. Of those patients taking cholinesterase inhibitors, 44.9% were also prescribed anticholinergic medications.

conclusionsOur cross-sectional, multicentre study found that people with dementia are commonly prescribed anticholinergic medications, even if concurrently taking cholinesterase inhibitors, and are significantly more likely to be discharged from hospital with a higher anticholinergic burden than on admission.

Indexed as

Cholinesterase InhibitorsDementiaAgedCholinergic AntagonistsCross-Sectional StudiesHospitalsHumansCholinergic AntagonistsCholinesterase InhibitorsAlzheimer diseaseAntidepressive agentsAntipsychotic agentsCholinesterase inhibitorsCognitionCognitive dysfunctionDementiaMemory disordersMuscarinic antagonistsPolypharmacy

Identifiers

PMID36203156
PMCPMC9541078
OpenAlexW4302307319

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.