Dataset Information

Anticholinergic medicines use among older adults before and after initiating dementia medicines.

ABSTRACT:

Aims

We investigated anticholinergic medicines use among older adults initiating dementia medicines.

Methods

We used Pharmaceutical Benefits Scheme dispensing claims to identify patients who initiated donepezil, rivastigmine, galantamine or memantine between 1 January 2013 and 30 June 2017 (after a period of ?180 days with no dispensing of these medicines) and remained on therapy for ?180 days (n = 4393), and dispensed anticholinergic medicines in the 180 days before and after initiating dementia medicines. We further examined anticholinergic medicines prescribed by a prescriber other than the one initiating dementia medicines.

Results

One-third of the study cohort (1439/4393) was exposed to anticholinergic medicines up to 180 days before or after initiating dementia medicines. Among patients exposed to anticholinergic medicines, 46% (659/1439) had the same medicine dispensed before and after initiating dementia medicines. The proportion of patients dispensed anticholinergic medicines increased by 2.5% (95% confidence interval [CI]: 1.3-3.7) after initiating dementia medicines. Antipsychotics use increased by 10.1% (95% CI: 7.6-12.7) after initiating dementia medicines; driven by increased risperidone use (7.3%, 95% CI: 5.3-9.3). Nearly half of patients dispensed anticholinergic medicines in the 180 days after (537/1133), were prescribed anticholinergic medicines by a prescriber other than the one initiating dementia medicines.

Conclusion

Use of anticholinergic medicines is common among patients initiating dementia medicines and this occurs against a backdrop of widespread campaigns to reduce irrational medicine combinations in this vulnerable population. Decisions about deprescribing medicines with questionable benefit among patients with dementia may be complicated by conflicting recommendations in prescribing guidelines.

SUBMITTER: Narayan SW

PROVIDER: S-EPMC6710547 | biostudies-literature | 2019 Sep

REPOSITORIES: biostudies-literature

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Publications

Anticholinergic medicines use among older adults before and after initiating dementia medicines.

Narayan Sujita W SW Pearson Sallie-Anne SA Litchfield Melisa M Le Couteur David G DG Buckley Nicholas N McLachlan Andrew J AJ Zoega Helga H

British journal of clinical pharmacology 20190707 9

<h4>Aims</h4>We investigated anticholinergic medicines use among older adults initiating dementia medicines.<h4>Methods</h4>We used Pharmaceutical Benefits Scheme dispensing claims to identify patients who initiated donepezil, rivastigmine, galantamine or memantine between 1 January 2013 and 30 June 2017 (after a period of ≥180 days with no dispensing of these medicines) and remained on therapy for ≥180 days (n = 4393), and dispensed anticholinergic medicines in the 180 days before and after ini ...[more]

PMID: 31046175

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Dataset Information

Anticholinergic medicines use among older adults before and after initiating dementia medicines.

Aims

Methods

Results

Conclusion

Publications

Anticholinergic medicines use among older adults before and after initiating dementia medicines.

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