Initiation of acetylcholinesterase inhibitors and complications of chronic airways disorders in elderly patients.

Initiation of acetylcholinesterase inhibitors and complications of chronic airways disorders in elderly patients. Research Abstract Details 

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Initiation of acetylcholinesterase inhibitors and complications of chronic airways disorders in elderly patients. Abstract Text:

Evan L Thacker,Sebastian Schneeweiss,

BACKGROUND AND OBJECTIVE: Acetylcholinesterase inhibitors (AChEIs), commonly prescribed in Alzheimer's disease, may trigger complications of chronic airways disorders. The aim of this study was to determine whether initiation of therapy with AChEIs contributes to complications of chronic airways disorders in an elderly population. METHODS: Sequence-symmetry analysis was used to assess two cohorts of patients, both with a history of chronic airways disorders. Both cohorts comprised Medicare beneficiaries who received drug coverage through the Pennsylvania Pharmaceutical Assistance Contract for the Elderly, between 1997 and 2002. One cohort of 922 patients initiated treatment with an AChEI; the other cohort of 2819 patients initiated treatment with a beta-adrenoceptor antagonist (beta-blocker), a comparator drug also contraindicated in chronic airways disorders. The occurrence of the following four outcomes in claims data was assessed: (i) emergency room visits for complications of chronic airways disorders; (ii) hospitalisations for complications of chronic airways disorders; (iii) physician visits for complications of chronic airways disorders; and (iv) dispensing of an antibacterial and an oral corticosteroid on the same day. Rate ratios (RRs) were adjusted for age, sex, race, nursing home residence, cognitive status, severity of chronic airways disorders, comorbid illnesses and all other patient characteristics that can be assumed to remain constant over the study period. RESULTS: Initiators of AChEIs had no detectable increased rate of complications of chronic airways disorders. Adjusted RRs of the four outcomes ranged from 1.00 (95% CI 0.61, 1.62; p = 0.99) for physician visits to 1.64 (95% CI 0.55, 4.89; p = 0.37) for emergency room visits, none reaching statistical significance. In contrast, beta-blocker initiators had significantly increased rates of all four outcomes after treatment, with adjusted RRs ranging from 1.97 (95% CI 1.18, 3.29; p = 0.009) for emergency room visits to 2.76 (95% CI 1.71, 4.45; p < 0.0001) for dispensing of an antibacterial and oral corticosteroid on the same day. CONCLUSION: These results suggest that, in current clinical practice, physicians can prescribe AChEIs safely to elderly patients with chronic airways disorders, while beta-blocker prescribing continues to result in adverse health outcomes.

Initiation of acetylcholinesterase inhibitors and complications of chronic airways disorders in elderly patients. Publishing Authors By Initials

EL Thacker,S Schneeweiss,

For similar respiratory tract diseases research abstracts see: respiratory tract diseases research

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MEDLINE DATE:

Initiation of acetylcholinesterase inhibitors and complications of chronic airways disorders in elderly patients. Journal Published:

PUBLICATION TYPE: Research Support, N.I.H., Extr

Journal: Drug safety : an international journal of medical

VOLUME: 29

Page Numbers: 1077-85

Journal Abbreviation:

ISSN: 0114-5916

DAY: 3

MONTH: 12

YEAR: 2006

Initiation of acetylcholinesterase inhibitors and complications of chronic airways disorders in elderly patients. Information

Number of References:

LANGUAGE: eng

NlmUniqueID: 9002928

Initiation of acetylcholinesterase inhibitors and complications of chronic airways disorders in elderly patients. Keywords Mesh Terms:

KEYWORDS: Respiratory Tract Diseases

MESH TERMS: chemically induced

Chemical & Substance for Abstract: Initiation of acetylcholinesterase inhibitors and complications of chronic airways disorders in elderly patients. Information

Substance Name: Galantamine

Registry Number: 357-70-0

Grant and Affiliation Information for Initiation of acetylcholinesterase inhibitors and complications of chronic airways disorders in elderly patients.

AFFILIATION: Division of Pharmacoepidemiology and Pharmacoeconomics, Harvard Medical School, Brigham and Women's Hospital, Boston, Massachusetts, USA. ethacker@hsph.harvard.edu

Country: New Zealand

AGENCY: United States AHRQ

GRANT: R01-HS10881

ACRONYM: HS

MEDLINETA: Drug Saf

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