Uso de medicamentos com acao anticolinergica em idosos e comparacao entre escalas de risco: estudo de base populacional /Use of anticholinergic drugs among the elderly and a comparison between risk scales: a population-based study

• Published in: Ciência & saude coletiva 2022-03, Vol.27 (3), p.1087
• Main Authors: Miranda, Vanessa Iribarrem Avena, Silveira, Marysabel Pinto Telis, Lutz, Barbara Heather, Pirolli, Flavia, Zambiasi, Lucas, Bielemann, Renata M, Gonzalez, Maria Cristina, Bertoldi, Andrea Damaso
• Format: Article
• Language: Portuguese
• ISSN: 1413-8123
• DOI: 10.1590/1413-81232022273.42002020

The pattern of morbidity and mortality has changed in recent years due to the increase in chronic noncommunicable diseases, leading to multiple comorbidities and the use of several medications. The scope of the study was to evaluate the anticholinergic drugs used by elderly people, according to risk scales. It involved a population-based cross-sectional study with elderly people. Socioeconomic factors, health problems, and medication use were investigated in the previous 15 days. The Anticholinergic Drug Scale (ADS), the Anticholinergic Risk Scale (ARS) and the Anticholinergic Cognitive Burden Scale (ACB) were used for risk classification according to anticholinergic activity of the drugs. A total of 1451 elderly people were interviewed and 1305 used medications, 60.7% of which with anticholinergic action, especially among the 80-year-old age bracket and the less educated. In total, 5703 drugs were used, 1282 (22.5%) of which with anticholinergic action. Kappa agreement of 0.63 was observed when assessing the ACB and ADS risk scales. The prevalence of the use of drugs with anticholinergic action was high, and attention should be paid to the consequences related to their use, with a view to more rational decision-making in clinical practice. Key words Drug use, Elderly, Cholinergic antagonists O padrao de morbimortalidade tem-se modificado nos ultimos anos com aumento das doengas cronicas nao-transmissiveis levando a multiplas comorbidades e ao uso de muitos medicamentos. O objetivo foi avaliar o uso de medicamentos com agao anticolinergica por idosos. Estudo transversal de base populacional, com individuos de 60 anos ou mais. Foram investigados fatores socioeconomicos, problemas de saude e utilizagao de medicamentos nos ultimos 15 dias. Para a classificagao dos medicamentos com atividade anticolinergica foram utilizadas as escalas: Anticholinergic Drug Scale (ADS), Anticholinergic Risc Scale (ARS), Anticolinergic Cognitive Burden Scale (ACB). Entrevistados 1.451 idosos, destes, 1.305 utilizaram medicamentos, sendo que 60,7% usaram fdrmacos com agao anticolinergica, sobretudo aqueles com mais de 80 anos e os menos escolarizados. No total, 5.703 medicamentos foram usados, 1.282 (22,5%) com agao anticolinergica. Observou-se concorddncia kappa de 0,63 quando se avaliou as escalas de risco ACB e ADS. A prevalencia de uso de fdrmacos com agao anticolinergica foi alta, deve-se estar atento as consequencias relativas ao seu uso, tendo em vista a tomada de decisao