Anticholinergic Drug Burden and Delirium: A Systematic Review

Objectives: To investigate the association between anticholinergic drug burden (ADB), measured with anticholinergic drug scales, and delirium and delirium severity. Design: Systematic review. Setting and Participants: All available studies. Methods: A systematic literature search was performed in Me...

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Autores: Egberts, Angelique, Moreno González, Rafael, Alan, Hava, Ziere, Gijsbertus, Mattace-Raso, Francesco
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2021
País:España
Institución:Universidad de Barcelona
Repositorio:Dipòsit Digital de la UB
OAI Identifier:oai:diposit.ub.edu:2445/173764
Acceso en línea:https://hdl.handle.net/2445/173764
Access Level:acceso abierto
Palabra clave:Deliri
Neurotransmissors
Delirium
Neurotransmitters
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spelling Anticholinergic Drug Burden and Delirium: A Systematic ReviewEgberts, AngeliqueMoreno González, RafaelAlan, HavaZiere, GijsbertusMattace-Raso, FrancescoDeliriNeurotransmissorsDeliriumNeurotransmittersObjectives: To investigate the association between anticholinergic drug burden (ADB), measured with anticholinergic drug scales, and delirium and delirium severity. Design: Systematic review. Setting and Participants: All available studies. Methods: A systematic literature search was performed in Medline, Embase, PsycINFO, Web of Science, CINAHL, Cochrane library, and Google Scholar. Studies evaluating the association between ADB (measured as a total score) and delirium or delirium severity, published in English, were eligible for inclusion. Results: Sixteen studies, including 148,756 persons, were included. Fifteen studies investigated delirium. ADB was measured with the Anticholinergic Risk Scale (ARS, n 1⁄4 5), the Anticholinergic Cognitive Burden Scale (ACB, n 1⁄4 6), the list of Chew (n 1⁄4 1), the Anticholinergic Drug Scale (ADS, n 1⁄4 5), a modified version of the ARS (n 1⁄4 1), and a modified version of the ACB (n 1⁄4 1). A high ADB, measured with the ARS, was associated with delirium (5/5). Also with the modified version of the ARS and ACB, an asso- ciation was found between a high ADB and delirium during 3-month (1/1) and 1-year follow-up (1/1), respectively. When ADB was assessed with other scales, the results were inconclusive, with only 1 positive association for the ACB (1/6) and ADS (1/5) each. The possible association between ADB and delirium severity has also been investigated (ADS n 1⁄4 2, Summers Drug Risk Number n 1⁄4 1). One study found an association between a high ADB, measured with the ADS, and an increase in severity of delirium. Conclusions and Implications: ADB assessed with the ARS is consistently associated with delirium. The association found between the modified versions of the ARS and ACB and delirium needs confirmation. When ADB was assessed with other scales, the findings were inconclusive. The current findings suggest that the ARS might be a useful tool to identify patients at increased risk for delirium.Elsevier Inc.2021info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://hdl.handle.net/2445/173764Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL))reponame:Dipòsit Digital de la UBinstname:Universidad de BarcelonaInglésReproducció del document publicat a: https://doi.org/10.1016/j.jamda.2020.04.019Journal of The American Medical Directors Association, 2021, vol. 22, num. 1, p. 65-74https://doi.org/10.1016/j.jamda.2020.04.019cc by (c) AMDA, The Society for Post-Acute and Long-Term Care Medicine, 2020http://creativecommons.org/licenses/by/3.0/es/info:eu-repo/semantics/openAccessoai:diposit.ub.edu:2445/1737642026-05-27T06:46:51Z
dc.title.none.fl_str_mv Anticholinergic Drug Burden and Delirium: A Systematic Review
title Anticholinergic Drug Burden and Delirium: A Systematic Review
spellingShingle Anticholinergic Drug Burden and Delirium: A Systematic Review
Egberts, Angelique
Deliri
Neurotransmissors
Delirium
Neurotransmitters
title_short Anticholinergic Drug Burden and Delirium: A Systematic Review
title_full Anticholinergic Drug Burden and Delirium: A Systematic Review
title_fullStr Anticholinergic Drug Burden and Delirium: A Systematic Review
title_full_unstemmed Anticholinergic Drug Burden and Delirium: A Systematic Review
title_sort Anticholinergic Drug Burden and Delirium: A Systematic Review
dc.creator.none.fl_str_mv Egberts, Angelique
Moreno González, Rafael
Alan, Hava
Ziere, Gijsbertus
Mattace-Raso, Francesco
author Egberts, Angelique
author_facet Egberts, Angelique
Moreno González, Rafael
Alan, Hava
Ziere, Gijsbertus
Mattace-Raso, Francesco
author_role author
author2 Moreno González, Rafael
Alan, Hava
Ziere, Gijsbertus
Mattace-Raso, Francesco
author2_role author
author
author
author
dc.subject.none.fl_str_mv Deliri
Neurotransmissors
Delirium
Neurotransmitters
topic Deliri
Neurotransmissors
Delirium
Neurotransmitters
description Objectives: To investigate the association between anticholinergic drug burden (ADB), measured with anticholinergic drug scales, and delirium and delirium severity. Design: Systematic review. Setting and Participants: All available studies. Methods: A systematic literature search was performed in Medline, Embase, PsycINFO, Web of Science, CINAHL, Cochrane library, and Google Scholar. Studies evaluating the association between ADB (measured as a total score) and delirium or delirium severity, published in English, were eligible for inclusion. Results: Sixteen studies, including 148,756 persons, were included. Fifteen studies investigated delirium. ADB was measured with the Anticholinergic Risk Scale (ARS, n 1⁄4 5), the Anticholinergic Cognitive Burden Scale (ACB, n 1⁄4 6), the list of Chew (n 1⁄4 1), the Anticholinergic Drug Scale (ADS, n 1⁄4 5), a modified version of the ARS (n 1⁄4 1), and a modified version of the ACB (n 1⁄4 1). A high ADB, measured with the ARS, was associated with delirium (5/5). Also with the modified version of the ARS and ACB, an asso- ciation was found between a high ADB and delirium during 3-month (1/1) and 1-year follow-up (1/1), respectively. When ADB was assessed with other scales, the results were inconclusive, with only 1 positive association for the ACB (1/6) and ADS (1/5) each. The possible association between ADB and delirium severity has also been investigated (ADS n 1⁄4 2, Summers Drug Risk Number n 1⁄4 1). One study found an association between a high ADB, measured with the ADS, and an increase in severity of delirium. Conclusions and Implications: ADB assessed with the ARS is consistently associated with delirium. The association found between the modified versions of the ARS and ACB and delirium needs confirmation. When ADB was assessed with other scales, the findings were inconclusive. The current findings suggest that the ARS might be a useful tool to identify patients at increased risk for delirium.
publishDate 2021
dc.date.none.fl_str_mv 2021
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://hdl.handle.net/2445/173764
url https://hdl.handle.net/2445/173764
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv Reproducció del document publicat a: https://doi.org/10.1016/j.jamda.2020.04.019
Journal of The American Medical Directors Association, 2021, vol. 22, num. 1, p. 65-74
https://doi.org/10.1016/j.jamda.2020.04.019
dc.rights.none.fl_str_mv cc by (c) AMDA, The Society for Post-Acute and Long-Term Care Medicine, 2020
http://creativecommons.org/licenses/by/3.0/es/
info:eu-repo/semantics/openAccess
rights_invalid_str_mv cc by (c) AMDA, The Society for Post-Acute and Long-Term Care Medicine, 2020
http://creativecommons.org/licenses/by/3.0/es/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv Elsevier Inc.
publisher.none.fl_str_mv Elsevier Inc.
dc.source.none.fl_str_mv Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL))
reponame:Dipòsit Digital de la UB
instname:Universidad de Barcelona
instname_str Universidad de Barcelona
reponame_str Dipòsit Digital de la UB
collection Dipòsit Digital de la UB
repository.name.fl_str_mv
repository.mail.fl_str_mv
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