PMH71 PREVALENCE OF CONCOMITANT USE OF ANTICHOLINERGIC MEDICATIONS AND CHOLINESTERASE INHIBITORS IN A MEDICAID NURSING HOME POPULATION

Background: Individuals with Parkinson’s disease (PD) may be especially vulnerable to future cognitive decline from anticholinergic medications. Objective: To characterize anticholinergic medication burden, determine the co-occurrence of anticholinergic and cholinesterase inhibitors, and to assess the correlations among anticholinergic burden scales in PD outpatients. Methods: We studied 670 PD outpatients enrolled in a clinic registry between 2012 and 2020. Anticholinergic burden was measured with the Anticholinergic Cognitive Burden Scale (ACB), Anticholinergic Drug Scale (ADS), Anticholinergic Risk Scale (ARS), and Drug Burden Index-Anticholinergic component (DBI-Ach). Correlations between scales were assessed with weighted kappa coefficients. Results: Between 31.5 to 46.3% of PD patients were taking medications with anticholinergic properties. Among the scales applied, the ACB produced the highest prevalence of medications with anticholinergic properties (46.3%). Considering only medications with definite anticholinergic activity (scores of 2 or 3 on ACB, ADS, or ARS), the most common anticholinergic drug classes were antiparkinsonian (8.2%), antipsychotic (6.4%), and urological (3.3%) medications. Cholinesterase inhibitors and medications with anticholinergic properties were co-prescribed to 5.4% of the total cohort. The most highly correlated scales were ACB and ADS (κ= 0.71), ACB and ARS (κ= 0.67), and ADS and ARS (κ= 0.55). Conclusion: A high proportion of PD patients (20%) were either taking antiparkinsonian, urological, or antipsychotic anticholinergic medications or were co-prescribed anticholinergic medications and cholinesterase inhibitors. By virtue of its detection of a high prevalence of anticholinergic medication usage and its high correlation with other scales, our data support use of the ACB scale to assess anticholinergic burden in PD patients.

Download Full-text

The vision of bedfast nursing home residents of their quality of life and the contribution of technological innovations in and around the bed

Journal of Enabling Technologies ◽

10.1108/jet-01-2018-0003 ◽

2018 ◽

Vol 12 (2) ◽

pp. 35-44

Author(s):

I. Martens ◽

H. Verbeek ◽

J. Aarts ◽

W.P.H. Bosems ◽

E. Felix ◽

...

Keyword(s):

Quality Of Life ◽

Nursing Home ◽

Short Form ◽

Nursing Home Residents ◽

Structured Interviews ◽

Nursing Home Population ◽

Social Contacts ◽

Content Type ◽

And Coping

Purpose Over 8 per cent of the Dutch nursing home population is bedfast, and this number is slowly increasing. The quality of life (QoL) of this population is lower than that of residents who are still mobile. Little research has been conducted on how to improve the QoL of this bedfast population, particularly through making technological adjustments to the bed and the direct surroundings. The purpose of this paper is to gain insight into the QoL of bedfast residents and how to improve this through technology. Design/methodology/approach A mixed-method multi-case study with thematic analysis was conducted in two nursing homes with seven participants based on semi-structured interviews and Short Form-12 questionnaire. Findings The major causes of the experienced low QoL were the limited opportunities for engaging in social contacts with others, and coping with the dependency on other people and having limited control. Participants suggested improvements of QoL through the application of modern communication technologies to engage in social contacts and to control the bed itself and environment around the bed. Practical implications The results may help improve the design of the bed and the direct environment in order to improve the QoL of bedfast nursing home residents. Originality/value The QoL of bedfast nursing home residents has not been studied before in relation to the bed itself and technological solutions that may help improve the QoL and level of control.

Download Full-text