Reducing the anticholinergic and sedative load in older patients on polypharmacy by pharmacist-led medication review: a randomised controlled trial

BMJ Open
Helene G van der MeerKatja Taxis

Abstract

To evaluate if a pharmacist-led medication review is effective at reducing the anticholinergic/sedative load, as measured by the Drug Burden Index (DBI). Randomised controlled single blind trial. 15 community pharmacies in the Northern Netherlands. 157 community-dwelling patients aged ≥65 years who used ≥5 medicines for ≥3 months, including at least one psycholeptic/psychoanaleptic medication and who had a DBI≥1. A medication review by the community pharmacist in collaboration with the patient's general practitioner and patient. The primary outcome was the proportion of patients whose DBI decreased by at least 0.5. Secondary outcomes were the presence of anticholinergic/sedative side effects, falls, cognitive function, activities of daily living, quality of life, hospital admission and mortality. Data were collected at baseline and 3 months follow-up. Mean participant age was 75.7 (SD, 6.9) years in the intervention arm and 76.6 (SD, 6.7) years in the control arm, the majority were female (respectively 69.3% and 72.0%). Logistic regression analysis showed no difference in the proportion of patients with a≥0.5 decrease in DBI between intervention arm (17.3%) and control arm (15.9%), (OR 1.04, CI 0.47 to 2.64, p=0.927). Intervent...Continue Reading

Associated Clinical Trials

References

Feb 1, 1991·Journal of the American Geriatrics Society·D Podsiadlo, S Richardson
Mar 31, 1998·Archives of Neurology·P R SolomonW W Pendlebury
Feb 13, 2001·BMJ : British Medical Journal·D J Torgerson
Oct 1, 1955·Journal of Consulting Psychology·R M REITAN
Apr 25, 2007·Archives of Internal Medicine·Sarah N HilmerDarrell R Abernethy
Jan 24, 2008·Journal of Clinical Pharmacy and Therapeutics·H BuurmaA C G Egberts
Apr 19, 2013·British Journal of Clinical Pharmacology·Ernieda HatahStephen B Duffull
Feb 5, 2014·The British Journal of Psychiatry : the Journal of Mental Science·Rebecca L GouldRobert J Howard
Feb 14, 2014·Journal of Clinical Pharmacy and Therapeutics·H F KwintM L Bouvy
Feb 20, 2014·British Journal of Clinical Pharmacology·Susanna M WallerstedtAnnika Strandell
Aug 2, 2014·Therapeutic Advances in Drug Safety·Hui Sian TayArduino A Mangoni
Aug 15, 2014·Health and Quality of Life Outcomes·Sieta T de VriesPetra Denig
Sep 27, 2015·European Journal of Clinical Pharmacology·Hyerim ParkYasufumi Sawada
Apr 25, 2016·International Journal of Clinical Pharmacy·Martina TeichertMichel Wensing
Sep 26, 2016·Research in Social & Administrative Pharmacy : RSAP·Natali JokanovicJ Simon Bell
Nov 29, 2016·British Journal of Clinical Pharmacology·Jean-Baptiste BeuscartAnne Spinewine
Jul 25, 2017·Research in Social & Administrative Pharmacy : RSAP·Anne Gerd GranasKatja Taxis
Nov 18, 2018·Value in Health : the Journal of the International Society for Pharmacoeconomics and Outcomes Research·Simone KreimeierWolfgang Greiner

❮ Previous
Next ❯

Citations

Feb 13, 2019·Pharmacoepidemiology and Drug Safety·Helene G van der MeerHans Wouters
Jun 27, 2019·British Journal of Clinical Pharmacology·V M SloeserwijN J de Wit
Aug 21, 2020·Journal of General Internal Medicine·Hanna E BloomfieldTimothy J Wilt
Oct 3, 2018·Expert Review of Clinical Pharmacology·Sarah N Hilmer
Sep 30, 2020·Mechanisms of Ageing and Development·Muhammad Usman AliParminder Raina
Nov 19, 2020·Alzheimer's & Dementia : Translational Research & Clinical Interventions·Kenneth RockwoodLindsay M K Wallace
Apr 7, 2021·BMC Medical Informatics and Decision Making·Melissa T BaysariSarah N Hilmer
May 4, 2021·Journal of Alzheimer's Disease : JAD·Taylor J KrivanekKirk R Daffner
Jun 23, 2021·British Journal of Clinical Pharmacology·Iva BužančićMaja Ortner Hadžiabdić
Jul 10, 2021·Journal of the American Pharmacists Association : JAPhA·Betul OkuyanHilal Ozcebe
Jan 11, 2022·Pain Management·Mohammad RababaNahedh Alawneh

❮ Previous
Next ❯

Methods Mentioned

BETA
pharmacotherapy

Software Mentioned

SPSS
MLwiN

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.