Associations between anticholinergic burden and adverse health outcomes in Parkinson disease

Autores
Crispo, James A. G.; Willis, Allison W.; Thibault, Dylan P.; Fortin, Yannick; Hays, Harlen D.; McNair, Douglas S.; Bjerre, Lise M.; Kohen, Dafna E.; Pérez Lloret, Santiago; Mattison, Donald R.; Krewski, Daniel
Año de publicación
2016
Idioma
inglés
Tipo de recurso
artículo
Estado
versión publicada
Descripción
Background Elderly adults should avoid medications with anticholinergic effects since they may increase the risk of adverse events, including falls, delirium, and cognitive impairment. However, data on anticholinergic burden are limited in subpopulations, such as individuals with Parkinson disease (PD). The objective of this study was to determine whether anticholinergic burden was associated with adverse outcomes in a PD inpatient population. Methods Using the Cerner Health Facts1database, we retrospectively examined anticholinergic medication use, diagnoses, and hospital revisits within a cohort of 16,302 PD inpatients admitted to a Cerner hospital between 2000 and 2011. Anticholinergic burden was computed using the Anticholinergic Risk Scale (ARS). Primary outcomes were associations between ARS score and diagnosis of fracture and delirium. Secondary outcomes included associations between ARS score and 30-day hospital revisits. Results Many individuals (57.8%) were prescribed non-PD medications with moderate to very strong anticholinergic potential. Individuals with the greatest ARS score (4) were morelikely to be diagnosed with fractures (adjusted odds ratio (AOR): 1.56, 95% CI: 1.29-1.88) and delirium (AOR: 1.61, 95% CI: 1.08-2.40) relative to those with no anticholinergic burden. Similarly, inpatients with the greatest ARS score were more likely to visit the emergency department (adjusted hazard ratio (AHR): 1.32, 95% CI: 1.10-1.58) and be readmitted (AHR: 1.16, 95% CI: 1.01-1.33) within 30-days of discharge. Conclusions We found a positive association between increased anticholinergic burden and adverse outcomes among individuals with PD. Additional pharmacovigilance studies are needed to better understand risks associated with anticholinergic medication use in PD.
Fil: Crispo, James A. G.. University of Ottawa; Canadá. University of Pennsylvania; Estados Unidos
Fil: Willis, Allison W.. University of Pennsylvania; Estados Unidos
Fil: Thibault, Dylan P.. University of Pennsylvania; Estados Unidos. University of Ottawa; Canadá
Fil: Fortin, Yannick. University of Ottawa; Canadá
Fil: Hays, Harlen D.. Cerner Corporation; Estados Unidos
Fil: McNair, Douglas S.. Cerner Corporation; Estados Unidos
Fil: Bjerre, Lise M.. University of Ottawa; Canadá
Fil: Kohen, Dafna E.. University of Ottawa; Canadá
Fil: Pérez Lloret, Santiago. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Investigaciones Cardiológicas. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Investigaciones Cardiológicas; Argentina
Fil: Mattison, Donald R.. University of Ottawa; Canadá. Risk Sciences International; Canadá
Fil: Krewski, Daniel. University of Ottawa; Canadá. Risk Sciences International; Canadá
Materia
Enfermedad de Parkinson
Medicamentos Anticolinérgicos
Delirio
Fracturas
Nivel de accesibilidad
acceso abierto
Condiciones de uso
https://creativecommons.org/licenses/by-nc-sa/2.5/ar/
Repositorio
CONICET Digital (CONICET)
Institución
Consejo Nacional de Investigaciones Científicas y Técnicas
OAI Identificador
oai:ri.conicet.gov.ar:11336/84674
Acceder
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oai_identifier_str oai:ri.conicet.gov.ar:11336/84674
network_acronym_str CONICETDig
repository_id_str 3498
network_name_str CONICET Digital (CONICET)
spelling Associations between anticholinergic burden and adverse health outcomes in Parkinson diseaseCrispo, James A. G.Willis, Allison W.Thibault, Dylan P.Fortin, YannickHays, Harlen D.McNair, Douglas S.Bjerre, Lise M.Kohen, Dafna E.Pérez Lloret, SantiagoMattison, Donald R.Krewski, DanielEnfermedad de ParkinsonMedicamentos AnticolinérgicosDelirioFracturashttps://purl.org/becyt/ford/3.3https://purl.org/becyt/ford/3Background Elderly adults should avoid medications with anticholinergic effects since they may increase the risk of adverse events, including falls, delirium, and cognitive impairment. However, data on anticholinergic burden are limited in subpopulations, such as individuals with Parkinson disease (PD). The objective of this study was to determine whether anticholinergic burden was associated with adverse outcomes in a PD inpatient population. Methods Using the Cerner Health Facts1database, we retrospectively examined anticholinergic medication use, diagnoses, and hospital revisits within a cohort of 16,302 PD inpatients admitted to a Cerner hospital between 2000 and 2011. Anticholinergic burden was computed using the Anticholinergic Risk Scale (ARS). Primary outcomes were associations between ARS score and diagnosis of fracture and delirium. Secondary outcomes included associations between ARS score and 30-day hospital revisits. Results Many individuals (57.8%) were prescribed non-PD medications with moderate to very strong anticholinergic potential. Individuals with the greatest ARS score (4) were morelikely to be diagnosed with fractures (adjusted odds ratio (AOR): 1.56, 95% CI: 1.29-1.88) and delirium (AOR: 1.61, 95% CI: 1.08-2.40) relative to those with no anticholinergic burden. Similarly, inpatients with the greatest ARS score were more likely to visit the emergency department (adjusted hazard ratio (AHR): 1.32, 95% CI: 1.10-1.58) and be readmitted (AHR: 1.16, 95% CI: 1.01-1.33) within 30-days of discharge. Conclusions We found a positive association between increased anticholinergic burden and adverse outcomes among individuals with PD. Additional pharmacovigilance studies are needed to better understand risks associated with anticholinergic medication use in PD.Fil: Crispo, James A. G.. University of Ottawa; Canadá. University of Pennsylvania; Estados UnidosFil: Willis, Allison W.. University of Pennsylvania; Estados UnidosFil: Thibault, Dylan P.. University of Pennsylvania; Estados Unidos. University of Ottawa; CanadáFil: Fortin, Yannick. University of Ottawa; CanadáFil: Hays, Harlen D.. Cerner Corporation; Estados UnidosFil: McNair, Douglas S.. Cerner Corporation; Estados UnidosFil: Bjerre, Lise M.. University of Ottawa; CanadáFil: Kohen, Dafna E.. University of Ottawa; CanadáFil: Pérez Lloret, Santiago. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Investigaciones Cardiológicas. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Investigaciones Cardiológicas; ArgentinaFil: Mattison, Donald R.. University of Ottawa; Canadá. Risk Sciences International; CanadáFil: Krewski, Daniel. University of Ottawa; Canadá. Risk Sciences International; CanadáPublic Library of Science2016-03info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttp://purl.org/coar/resource_type/c_6501info:ar-repo/semantics/articuloapplication/pdfapplication/pdfhttp://hdl.handle.net/11336/84674Crispo, James A. G.; Willis, Allison W.; Thibault, Dylan P.; Fortin, Yannick; Hays, Harlen D.; et al.; Associations between anticholinergic burden and adverse health outcomes in Parkinson disease; Public Library of Science; Plos One; 11; 3; 3-2016; 21-28; e01506211932-6203CONICET DigitalCONICETenginfo:eu-repo/semantics/altIdentifier/doi/10.1371/journal.pone.0150621info:eu-repo/semantics/altIdentifier/url/https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0150621info:eu-repo/semantics/openAccesshttps://creativecommons.org/licenses/by-nc-sa/2.5/ar/reponame:CONICET Digital (CONICET)instname:Consejo Nacional de Investigaciones Científicas y Técnicas2025-09-29T10:22:32Zoai:ri.conicet.gov.ar:11336/84674instacron:CONICETInstitucionalhttp://ri.conicet.gov.ar/Organismo científico-tecnológicoNo correspondehttp://ri.conicet.gov.ar/oai/requestdasensio@conicet.gov.ar; lcarlino@conicet.gov.arArgentinaNo correspondeNo correspondeNo correspondeopendoar:34982025-09-29 10:22:33.118CONICET Digital (CONICET) - Consejo Nacional de Investigaciones Científicas y Técnicasfalse
dc.title.none.fl_str_mv Associations between anticholinergic burden and adverse health outcomes in Parkinson disease
title Associations between anticholinergic burden and adverse health outcomes in Parkinson disease
spellingShingle Associations between anticholinergic burden and adverse health outcomes in Parkinson disease
Crispo, James A. G.
Enfermedad de Parkinson
Medicamentos Anticolinérgicos
Delirio
Fracturas
title_short Associations between anticholinergic burden and adverse health outcomes in Parkinson disease
title_full Associations between anticholinergic burden and adverse health outcomes in Parkinson disease
title_fullStr Associations between anticholinergic burden and adverse health outcomes in Parkinson disease
title_full_unstemmed Associations between anticholinergic burden and adverse health outcomes in Parkinson disease
title_sort Associations between anticholinergic burden and adverse health outcomes in Parkinson disease
dc.creator.none.fl_str_mv Crispo, James A. G.
Willis, Allison W.
Thibault, Dylan P.
Fortin, Yannick
Hays, Harlen D.
McNair, Douglas S.
Bjerre, Lise M.
Kohen, Dafna E.
Pérez Lloret, Santiago
Mattison, Donald R.
Krewski, Daniel
author Crispo, James A. G.
author_facet Crispo, James A. G.
Willis, Allison W.
Thibault, Dylan P.
Fortin, Yannick
Hays, Harlen D.
McNair, Douglas S.
Bjerre, Lise M.
Kohen, Dafna E.
Pérez Lloret, Santiago
Mattison, Donald R.
Krewski, Daniel
author_role author
author2 Willis, Allison W.
Thibault, Dylan P.
Fortin, Yannick
Hays, Harlen D.
McNair, Douglas S.
Bjerre, Lise M.
Kohen, Dafna E.
Pérez Lloret, Santiago
Mattison, Donald R.
Krewski, Daniel
author2_role author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Enfermedad de Parkinson
Medicamentos Anticolinérgicos
Delirio
Fracturas
topic Enfermedad de Parkinson
Medicamentos Anticolinérgicos
Delirio
Fracturas
purl_subject.fl_str_mv https://purl.org/becyt/ford/3.3
https://purl.org/becyt/ford/3
dc.description.none.fl_txt_mv Background Elderly adults should avoid medications with anticholinergic effects since they may increase the risk of adverse events, including falls, delirium, and cognitive impairment. However, data on anticholinergic burden are limited in subpopulations, such as individuals with Parkinson disease (PD). The objective of this study was to determine whether anticholinergic burden was associated with adverse outcomes in a PD inpatient population. Methods Using the Cerner Health Facts1database, we retrospectively examined anticholinergic medication use, diagnoses, and hospital revisits within a cohort of 16,302 PD inpatients admitted to a Cerner hospital between 2000 and 2011. Anticholinergic burden was computed using the Anticholinergic Risk Scale (ARS). Primary outcomes were associations between ARS score and diagnosis of fracture and delirium. Secondary outcomes included associations between ARS score and 30-day hospital revisits. Results Many individuals (57.8%) were prescribed non-PD medications with moderate to very strong anticholinergic potential. Individuals with the greatest ARS score (4) were morelikely to be diagnosed with fractures (adjusted odds ratio (AOR): 1.56, 95% CI: 1.29-1.88) and delirium (AOR: 1.61, 95% CI: 1.08-2.40) relative to those with no anticholinergic burden. Similarly, inpatients with the greatest ARS score were more likely to visit the emergency department (adjusted hazard ratio (AHR): 1.32, 95% CI: 1.10-1.58) and be readmitted (AHR: 1.16, 95% CI: 1.01-1.33) within 30-days of discharge. Conclusions We found a positive association between increased anticholinergic burden and adverse outcomes among individuals with PD. Additional pharmacovigilance studies are needed to better understand risks associated with anticholinergic medication use in PD.
Fil: Crispo, James A. G.. University of Ottawa; Canadá. University of Pennsylvania; Estados Unidos
Fil: Willis, Allison W.. University of Pennsylvania; Estados Unidos
Fil: Thibault, Dylan P.. University of Pennsylvania; Estados Unidos. University of Ottawa; Canadá
Fil: Fortin, Yannick. University of Ottawa; Canadá
Fil: Hays, Harlen D.. Cerner Corporation; Estados Unidos
Fil: McNair, Douglas S.. Cerner Corporation; Estados Unidos
Fil: Bjerre, Lise M.. University of Ottawa; Canadá
Fil: Kohen, Dafna E.. University of Ottawa; Canadá
Fil: Pérez Lloret, Santiago. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Investigaciones Cardiológicas. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Investigaciones Cardiológicas; Argentina
Fil: Mattison, Donald R.. University of Ottawa; Canadá. Risk Sciences International; Canadá
Fil: Krewski, Daniel. University of Ottawa; Canadá. Risk Sciences International; Canadá
description Background Elderly adults should avoid medications with anticholinergic effects since they may increase the risk of adverse events, including falls, delirium, and cognitive impairment. However, data on anticholinergic burden are limited in subpopulations, such as individuals with Parkinson disease (PD). The objective of this study was to determine whether anticholinergic burden was associated with adverse outcomes in a PD inpatient population. Methods Using the Cerner Health Facts1database, we retrospectively examined anticholinergic medication use, diagnoses, and hospital revisits within a cohort of 16,302 PD inpatients admitted to a Cerner hospital between 2000 and 2011. Anticholinergic burden was computed using the Anticholinergic Risk Scale (ARS). Primary outcomes were associations between ARS score and diagnosis of fracture and delirium. Secondary outcomes included associations between ARS score and 30-day hospital revisits. Results Many individuals (57.8%) were prescribed non-PD medications with moderate to very strong anticholinergic potential. Individuals with the greatest ARS score (4) were morelikely to be diagnosed with fractures (adjusted odds ratio (AOR): 1.56, 95% CI: 1.29-1.88) and delirium (AOR: 1.61, 95% CI: 1.08-2.40) relative to those with no anticholinergic burden. Similarly, inpatients with the greatest ARS score were more likely to visit the emergency department (adjusted hazard ratio (AHR): 1.32, 95% CI: 1.10-1.58) and be readmitted (AHR: 1.16, 95% CI: 1.01-1.33) within 30-days of discharge. Conclusions We found a positive association between increased anticholinergic burden and adverse outcomes among individuals with PD. Additional pharmacovigilance studies are needed to better understand risks associated with anticholinergic medication use in PD.
publishDate 2016
dc.date.none.fl_str_mv 2016-03
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
http://purl.org/coar/resource_type/c_6501
info:ar-repo/semantics/articulo
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv http://hdl.handle.net/11336/84674
Crispo, James A. G.; Willis, Allison W.; Thibault, Dylan P.; Fortin, Yannick; Hays, Harlen D.; et al.; Associations between anticholinergic burden and adverse health outcomes in Parkinson disease; Public Library of Science; Plos One; 11; 3; 3-2016; 21-28; e0150621
1932-6203
CONICET Digital
CONICET
url http://hdl.handle.net/11336/84674
identifier_str_mv Crispo, James A. G.; Willis, Allison W.; Thibault, Dylan P.; Fortin, Yannick; Hays, Harlen D.; et al.; Associations between anticholinergic burden and adverse health outcomes in Parkinson disease; Public Library of Science; Plos One; 11; 3; 3-2016; 21-28; e0150621
1932-6203
CONICET Digital
CONICET
dc.language.none.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv info:eu-repo/semantics/altIdentifier/doi/10.1371/journal.pone.0150621
info:eu-repo/semantics/altIdentifier/url/https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0150621
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
https://creativecommons.org/licenses/by-nc-sa/2.5/ar/
eu_rights_str_mv openAccess
rights_invalid_str_mv https://creativecommons.org/licenses/by-nc-sa/2.5/ar/
dc.format.none.fl_str_mv application/pdf
application/pdf
dc.publisher.none.fl_str_mv Public Library of Science
publisher.none.fl_str_mv Public Library of Science
dc.source.none.fl_str_mv reponame:CONICET Digital (CONICET)
instname:Consejo Nacional de Investigaciones Científicas y Técnicas
reponame_str CONICET Digital (CONICET)
collection CONICET Digital (CONICET)
instname_str Consejo Nacional de Investigaciones Científicas y Técnicas
repository.name.fl_str_mv CONICET Digital (CONICET) - Consejo Nacional de Investigaciones Científicas y Técnicas
repository.mail.fl_str_mv dasensio@conicet.gov.ar; lcarlino@conicet.gov.ar
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score 13.070432

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