4CPS-093 Polypharmacy and inappropriate drugs in patients with oropharyngeal dysphagia

• Published in: European journal of hospital pharmacy. Science and practice 2023-03, Vol.30 (Suppl 1), p.A53-A54
• Main Authors: Rodríguez Marín, M, Delgado-Silveira, E, Mora-Rivas, E, Montes-Jovellar-Gonzalez, LE, Muñoz-Garcia, M, Vicente-Oliveros, N, Palomar-Fernandez, C, Alvarez Diaz, AM
• Format: Article
• Language: English
• Subjects: Conflicts of interest; Drugs; Dysphagia; Otolaryngology; Polypharmacy; Section 4: Clinical pharmacy services
• ISSN: 2047-9956; 2047-9964
• DOI: 10.1136/ejhpharm-2023-eahp.113

Background and ImportanceOropharyngeal Dysphagia (OD) is a symptom where patients who present it usually have multiple nutritional, functional, morbidity and quality of life complications. It is associated with a higher incidence of aspiration pneumonia. OD can be caused by adverse effects of medications, such as dopamine antagonists (DA), central nervous system depressants (CNSD), anticholinergic drugs, which block the action of acetylcholine, among others.Aim and ObjectivesTo analyse the prevalence of polypharmacy (≥ 5 chronic drugs) and inappropriate drugs (anticholinergics and CNSD) in patients with OD. It was also calculated anticholinergic risk (AR) using different anticholinergic scales (AS).Material and MethodsA retrospective observational study was carried out in a general tertiary hospital. Data from patients diagnosed with OD were collected from the otorhinolaryngology consultation of years 2019-2021. Demographical, clinical and pharmacotherapeutic data were obtained from the electronic medical record. AR was calculated using anticholinergic scales (AS) with the anticholinergic burden calculator (available at www.anticholinergicscales.es).ResultsSixty patients were recruited; 4 were low due to not having their medication prescription record. Of the 56 remaining patients, 28 (50%) were men. The average age was 73.2 years [14.5-90.3].Forty-three (76.79%) patients were polymedicated. 461 drugs were analysed, finding 104 (22.56%) potential medications to cause OD. Of these, 91 (19.74%) were drugged with AR,13 (2.82%) were CNSD and 7 (1.52%) were DA . When analysing the AS scale it was found: that 12 (21.42%) patients had a high-risk AR, 15 (26.78%) had medium risk load and 3 (5.36%) patients had low risk AR being mostly men (56.66%). The most repeated drug was tamsulosin (1.73%).Conclusion and RelevanceIt is observed that there is a high percentage of patients with OD are polymedicated. The prevalence of AR is high. A good pharmacological review with AS must be carried out and try to make a description, to reduce the anticholinergic load and the number of drugs.References and/or AcknowledgementsConflict of InterestNo conflict of interest