The concurrent use of anticholinergics and cholinesterase inhibitors: rare event or common practice?

The concurrent use of anticholinergics and cholinesterase inhibitors: rare event or common practice? Research Abstract Details 

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The concurrent use of anticholinergics and cholinesterase inhibitors: rare event or common practice? Abstract Text:

OBJECTIVES: To measure the prevalence of anticholinergic use cross-sectionally in patients receiving cholinesterase inhibitors and to describe change in use of anticholinergics upon inception of cholinesterase inhibitor treatment. DESIGN: Cross-sectional and inception cohort studies. SETTING: State of Iowa. PARTICIPANTS: Iowa Medicaid beneficiaries aged 50 and older with a pharmacy claim for a cholinesterase inhibitor during January 1997 through February 2000. MEASUREMENTS: Anticholinergic use was determined for all patients with a cholinesterase inhibitor pharmacy claim during January and February of 2000. A frequency distribution of all anticholinergics was compiled, with emphasis placed on those considered inappropriate in the elderly. In a separate analysis, anticholinergic use was determined at two points: 90 days before and after cholinesterase inhibitor inception. RESULTS: Of 557 patients receiving a cholinesterase inhibitor, 197 (35.4%) received an anticholinergic concurrently. Of all anticholinergics, 74.5% (178/239) had been identified as inappropriate for use in the elderly, 22.2% (53/239) under any circumstances. At the time of cholinesterase inhibitor inception, 30.2% (143/474) and 33.5% (159/474) of patients received an anticholinergic 90 days before and 90 days after inception, respectively. Increases in anticholinergic prescribing upon cholinesterase inhibitor inception exceeded decreases (Wilcoxon signed-rank test, S=529, P=.020). CONCLUSION: The concurrent use of anticholinergics and cholinesterase inhibitors is common although rarely appropriate. Patients with Alzheimer's disease deserve to receive the optimum benefit from cholinesterase inhibitor treatment, which can only be achieved through diligent and appropriate use of concurrent pharmacotherapy.

The concurrent use of anticholinergics and cholinesterase inhibitors: rare event or common practice? Publishing Authors By Initials

For similar therapeutics: drug therapy: polypharmacy research abstracts see: therapeutics: drug therapy: polypharmacy research

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The concurrent use of anticholinergics and cholinesterase inhibitors: rare event or common practice? Journal Published:

PUBLICATION TYPE: Journal Article

Journal: Journal of the American Geriatrics Society

VOLUME: 52

Page Numbers: 2082-7

Journal Abbreviation: J Am Geriatr Soc

ISSN: 0002-8614

DAY: 10

MONTH: Dec

YEAR: 2004

The concurrent use of anticholinergics and cholinesterase inhibitors: rare event or common practice? Information

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LANGUAGE: eng

NlmUniqueID: 7503062

The concurrent use of anticholinergics and cholinesterase inhibitors: rare event or common practice? Keywords Mesh Terms:

KEYWORDS: Polypharmacy

MESH TERMS: statistics & numerical data

Chemical & Substance for Abstract: The concurrent use of anticholinergics and cholinesterase inhibitors: rare event or common practice? Information

Substance Name: Cholinesterase Inhibitors

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Grant and Affiliation Information for The concurrent use of anticholinergics and cholinesterase inhibitors: rare event or common practice?

AFFILIATION: Clinical and Administrative Pharmacy, College of Pharmacy, University of Iowa, Iowa City, USA. ryan-carnahan@okhse.edu <ryan-carnahan@okhse.edu>

Country: United States

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MEDLINETA: J Am Geriatr Soc

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