The risk of delirium and falls or fractures with the use of overactive bladder anticholinergic medications

Author(s):  
Blayne Welk ◽  
Khaled Etaby ◽  
Eric McArthur ◽  
Queena Chou
2016 ◽  
Vol 10 (7-8) ◽  
pp. 277 ◽  
Author(s):  
Christopher J.D. Wallis ◽  
Colin Lundeen ◽  
Nicole Golda ◽  
Hilary Brotherhood ◽  
Peter Pommerville ◽  
...  

<p><strong>Introduction:</strong> We sought to understand the contemporary pharmacologic management of overactive bladder (OAB) in a single-payer system. We examined temporal trends in the use of anticholinergic<br />medications and assessed whether the likelihood of patients changing their anticholinergic therapy was predicted by their current therapy.</p><p><strong>Methods:</strong> We conducted a retrospective, population-based analysis of prescription records from the PharmaNet database in BC, Canada. We identified patients treated with one or more anticholinergic<br />prescriptions between 2001 and 2009. We characterized temporal trends in the use of anticholinergic medications. We used generalized estimating equations with a logit wing to assess the relationship between the type of anticholinergic medication and the change in prescription.</p><p><strong>Results:</strong> The 114 325 included patients filled 1 140 296 anticholinergic prescriptions. The number of prescriptions each year increased over the study, both in aggregate and for each individual medication. While oxybutynin was the most commonly prescribed medication (68% of all prescriptions), the proportion of newer anticholinergics (solifenacin, darifenacin, and trospium) prescribed increased over time (p&lt;0.0001). Patients taking tolterodine (odds ratio [OR] 1.03; p=0.01) and darifenacin (OR 1.12; p=0.0006) were significantly more likely to change their prescription than those taking oxybutynin. There was no association seen for patients taking solifenacin (p=0.6) and trospium (p=0.9).</p><p><strong>Conclusions:</strong> There are an increasing number of anticholinergic prescriptions being filled annually. Patients taking newer anticholinergics are at least as likely to change therapy as those taking<br />oxybutynin. The reimbursement environment in BC likely affects these results. Restrictions in the available data limit assessment of other relevant predictors.</p>


2019 ◽  
Vol 31 (12) ◽  
pp. 2653-2660 ◽  
Author(s):  
Shilpa Iyer ◽  
Svjetlana Lozo ◽  
Carolyn Botros ◽  
Chi Wang ◽  
Alexandra Warren ◽  
...  

2010 ◽  
Vol 183 (4S) ◽  
Author(s):  
Jocelyn Rieder ◽  
Stephanie Tovar ◽  
Elizabeth Johnston ◽  
Ali Zhumkhawala ◽  
Viet Tran ◽  
...  

Author(s):  
Angel L. Ball ◽  
Adina S. Gray

Pharmacological intervention for depressive symptoms in institutionalized elderly is higher than the population average. Among the patients on such medications are those with a puzzling mix of symptoms, diagnosed as “dementia syndrome of depression,” formerly termed “pseudodementia”. Cognitive-communicative changes, potentially due to medications, complicate the diagnosis even further. This discussion paper reviews the history of the terminology of “pseudodementia,” and examines the pharmacology given as treatment for depressive symptoms in the elderly population that can affect cognition and communication. Clinicians can reduce the risk of misdiagnosis or inappropriate treatment by having an awareness of potential side effects, including decreased attention, memory, and reasoning capacities, particularly due to some anticholinergic medications. A team approach to care should include a cohesive effort directed at caution against over-medication, informed management of polypharmacology, enhancement of environmental/communication supports and quality of life, and recognizing the typical nature of some depressive signs in elderly institutionalized individuals.


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