PMID- 32466526
OWN - NLM
STAT- MEDLINE
DCOM- 20201019
LR  - 20240329
IS  - 1660-4601 (Electronic)
IS  - 1661-7827 (Print)
IS  - 1660-4601 (Linking)
VI  - 17
IP  - 11
DP  - 2020 May 26
TI  - Anticholinergic Burden and Safety Outcomes in Older Patients with Chronic 
      Hepatitis C: A Retrospective Cohort Study.
LID - 10.3390/ijerph17113776 [doi]
LID - 3776
AB  - AIM: Older patients with chronic hepatitis C infection starting direct-acting 
      antivirals (DAAs) are frequently prescribed multiple medications that may be 
      categorized as inappropriate. Anticholinergic burden has been shown to be a 
      predictor of adverse health and functional outcomes. Different scales are 
      available to calculate anticholinergic burden. The aim of this study was to 
      determine the prevalence of anticholinergic medication among older patients 
      treated with DAAs and the risk factors associated using the Anticholinergic 
      Cognitive Burden (ACB) scale, the Anticholinergic Risk Scale (ARS) and the 
      Anticholinergic Drug Scale (ADS) and analyze the resulting safety consequences. 
      METHODS: Observational, retrospective cohort study of consecutive patients >/=65 
      years old receiving DAAs and taking concomitant medication. This study was 
      conducted in accordance with the Strengthening the Reporting of observational 
      studies in Epidemiology Statement. RESULTS: 236 patients were included. The 
      average age was 71.7 years, 73.3% cirrhotic, and 47% patients took >/=5 medicines. 
      According to the ACB, ARS and ADS scales, 35.2% (n = 83), 10.6% (n = 25) and 
      34.3% (n = 81) of the patients were treated with anticholinergic medication. Two 
      hundred-and-six (86%) patients presented any adverse events (AEs) during therapy. 
      ARS scale showed a significant relationship between presence of anticholinergic 
      medication and AEs. A large number of patients suffered anticholinergic events, 
      with more events per patient in patients taking anticholinergic drugs. 
      CONCLUSIONS: Older hepatitis C chronic patients are exposed to potentially 
      inappropriate polypharmacy and anticholinergic risk, according to the ACB, ARS 
      and ADS scales. The three scales showed different results. Only the ARS scale was 
      associated with AEs, but the rate of anticholinergic effects per patient was 
      significantly higher in patients with anticholinergic drugs, regardless of the 
      scale used. Consider quality of pharmacotherapy when starting DAA with a 
      multidisciplinary approach could improve health outcomes.
FAU - Amoros-Reboredo, Patricia
AU  - Amoros-Reboredo P
AD  - Pharmacy Service Hospital Clinic de Barcelona, 08036 Barcelona, Spain.
FAU - Soy, Dolors
AU  - Soy D
AD  - Pharmacy Service Division of Medicines Hospital Clinic de Barcelona, University 
      of Barcelona, IDIBAPS, 08036 Barcelona, Spain.
FAU - Hernandez-Hernandez, Marta
AU  - Hernandez-Hernandez M
AD  - School of Health Sciences Blanquerna, University Ramon Llull, 08025 Barcelona, 
      Spain.
FAU - Lens, Sabela
AU  - Lens S
AD  - Liver Unit Hospital Clinic de Barcelona, University of Barcelona, IDIBAPS, 08036 
      Barcelona, Spain.
AD  - Centro de Investigacion Biomedica Red de Enfermedades Hepaticas y Digestivas 
      (CIBERehd), 28029 Madrid, Spain.
FAU - Mestres, Conxita
AU  - Mestres C
AD  - School of Health Sciences Blanquerna, University Ramon Llull, 08025 Barcelona, 
      Spain.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20200526
PL  - Switzerland
TA  - Int J Environ Res Public Health
JT  - International journal of environmental research and public health
JID - 101238455
RN  - 0 (Antiviral Agents)
RN  - 0 (Cholinergic Antagonists)
SB  - IM
MH  - Aged
MH  - *Antiviral Agents/therapeutic use
MH  - *Cholinergic Antagonists/adverse effects
MH  - Female
MH  - Humans
MH  - *Liver Neoplasms
MH  - Male
MH  - *Polypharmacy
MH  - Retrospective Studies
PMC - PMC7311997
OTO - NOTNLM
OT  - adverse events
OT  - ageing
OT  - drug use
OT  - patient safety
OT  - polypharmacy
COIS- S.L. has acted as advisor for AbbVie, Janssen, and Gilead. The remaining authors 
      have nothing to declare.
EDAT- 2020/05/30 06:00
MHDA- 2020/10/21 06:00
PMCR- 2020/06/01
CRDT- 2020/05/30 06:00
PHST- 2020/03/29 00:00 [received]
PHST- 2020/05/15 00:00 [revised]
PHST- 2020/05/21 00:00 [accepted]
PHST- 2020/05/30 06:00 [entrez]
PHST- 2020/05/30 06:00 [pubmed]
PHST- 2020/10/21 06:00 [medline]
PHST- 2020/06/01 00:00 [pmc-release]
AID - ijerph17113776 [pii]
AID - ijerph-17-03776 [pii]
AID - 10.3390/ijerph17113776 [doi]
PST - epublish
SO  - Int J Environ Res Public Health. 2020 May 26;17(11):3776. doi: 
      10.3390/ijerph17113776.