5PSQ-021 Patient’s and physician’s acceptance of a pharmacist-led intervention to reduce anticholinergic burden

• Published in: European journal of hospital pharmacy. Science and practice 2022-03, Vol.29 (Suppl 1), p.A124-A125
• Main Authors: Rodriguez-Ramallo, H, Prado-Mel, E, Villalba-Moreno, Á, Galbá-Borrás, MI, Ramos-Romero, R, Del Valle Moreno, P, Sanchez-Fidalgo, S
• Format: Article
• Language: English
• Subjects: Anesthesia; Comorbidity; Conflicts of interest; Drug dosages; Drug withdrawal; Intervention; Nursing homes; Patients; Pharmacists; Physicians; Prescription drugs; Section 5: Patient safety and quality assurance
• ISSN: 2047-9956; 2047-9964
• DOI: 10.1136/ejhpharm-2022-eahp.260

Background and importanceThe anticholinergic burden has been repeatedly associated with adverse events in elderly patients.Aim and objectivesWe aimed to determine the acceptance of a pharmacist-led intervention to reduce the anticholinergic burden.Material and methodsDesign: interventional prospective study carried out from January to May 2021.Population: institutionalised patients from a Spanish nursing home.Variables collected: sex, age, prescribed drugs, prescribed anticholinergic drugs (ADs) according to Drug Burden Index (https://www.anticholinergicscales.es/), Charlson Comorbidity index, Barthel index, intervention proposals and intervention acceptance.Pharmacists led the design of the treatment interventions: every patient was interviewed and their treatment reviewed; the pharmacist then proposed treatment modifications of ADs on deprescription (withdrawal, dose reduction or switch), these modifications were evaluated by physicians and later offered to patients.The study was carried out according to national ethical standards, and patients’ written consents were collected.Statistical analyses were carried out with Pearson’s Chi-square test.ResultsOverall, of 157 patients who resided in the nursing home, 99 (63.1%) received anticholinergics and were assessed for intervention. 59.6% men, mean age 72.5±7.9 years, median Charlson Comorbidity index: 2 (0–9), mean Barthel index: 88.0±15.2. Median prescribed drugs: 10 (1–19), median prescribed ADs: 2 (1–5).Treatment modifications were proposed for 37 patients who received a total of 85 ADs. Overall, 97 treatment modification proposals were designed.Abtsract 5PSQ-021 Table 1 Interventions Intervention proposals Accepted by physicians Accepted by patients Withdrawal 47 (48.4%) 28 (59.6%) 22 (46.8%) Dose reduction 41 (42.3%) 22 (53.7%) 12 (29.3%) Switch 9 (9.3%) 5 (55.6%) 4 (44.4%) Total 97 56 39 39 interventions were finally accepted. No statistically significant differences in acceptance were found according to intervention design (p>0.05).The ADs most frequently proposed for intervention were: tramadol (15), pregabalin (9), lorazepam (8), alprazolam (8) and tamsulosin (7).Interventions over anxiolytics and sedatives were rejected significantly more often by patients when compared to other drugs (p