A study evaluating the deprescribing guideline on anticholinergic drugs in a long-term care facility in Malta

Abstract

BACKGROUND: This study synthesizes the ‘Deprescribing Guideline: Anticholinergic Drugs’ from Mater Dei Hospital in Malta, emphasizing the critical role of medication choice in minimizing side effects for elderly patients, particularly those experiencing polypharmacy. The guideline employs the Anticholinergic Burden (ACB) score, with a cumulative score of 3+ correlating with elevated cognitive impairment and mortality. Polypharmacy, often linked to confusion and increased morbidity in the elderly, necessitates a proactive approach to medication management. The guideline recommends alternative medications with reduced anticholinergic side effects and prompts clinicians to review treatment charts.

OBJECTIVE: To identify treatment charts with an ACB score exceeding 2 and assess adherence to the guideline.

METHOD: Data was collected retrospectively and all treatment charts valid in June 2023 were evaluated within the New Block at the long-term care facility St Vincent De Paul Residence (SVPR).

RESULTS: The findings revealed a notable prevalence of such charts, highlighting the imperative to address the anticholinergic burden in elderly patients. Evaluation of adherence indicated room for improvement in implementing deprescribing strategies.

CONCLUSION: This study underscores the significance of the Mater Dei Hospital guideline in optimizing medication regimens for elderly individuals, advocating for a proactive approach to enhance patient outcomes and reduce associated risks.