Are high-risk anticholinergic medicines prescribed too often for older adults?

Anticholinergics are a class of medications that are often prescribed for allergies, lung disease, and urinary incontinence. They can also increase health risks for older adults, affecting memory and ability to think, and an increased risk of falls, dementia, and death.

Recently, a team of researchers decided to study how frequently healthcare providers prescribe potentially inappropriate medications like anticholinergics in light of recommendations like those from the AGS Beers Criteria for Potentially Inappropriate Medication Use in Older Adults.

The researchers used information from the 2006-2015 National Ambulatory Medical Care Survey (NAMCS), an annual survey of office-based physician visits. The researchers looked only at visits for people aged 65 or older.

The researchers focused on the 35 anticholinergics that healthcare professionals are advised to avoid for older adults. Among them were antidepressants, medications used to treat overactive bladder and Parkinson’s disease, antihistamines, muscle relaxants, and treatments for people who live with muscle spasms.

The researchers learned that between 2006 and 2015, 6.2% of older adult visits to a physician resulted in a prescription for a ‘high-risk’ anticholinergic. Older women who had more than two chronic conditions were also the most likely to be prescribed potentially inappropriate anticholinergics. They were most often diagnosed with overactive bladder or urinary incontinence, nerve pain, dizziness, or motion sickness.

Interestingly, the researchers noted that the trend for prescribing these high-risk treatments had fallen by about 2% between 2008 / 2009 and 2014 / 2015.

The researchers concluded that their findings suggest that future research should be conducted to help create better care practices aimed at reducing the use of high-risk anticholinergic prescriptions for older adults.

The study is published in the Journal of the American Geriatrics Society.