Anticholinergic Medication Use May Increase Hospital Visits

A study conducted at Indiana University Center for Aging Research, Indiana University (IU) Center for Health Innovation and Implementation Science, and Regenstrief Institute, has found that older adults taking anticholinergic medications may visit the hospital more often. Both prescription and over-the-counter medications used to treat depression, pain and sleep problems, contain anticholinergic drugs.

According to the study – which was published in the journal, Phamacotherapy – as many as 50 percent of adults 65 years and older regularly use drugs with anticholinergic properties, with some individuals taking multiple anticholinergic medications on a regular basis. Using the Regenstrief Medical Record System, the investigators of the current study analyzed dispensing data for prescription drugs to determine how much of these drugs patients are taking, and compares them to hospital and emergency department visits.

“Anticholinergics, the medications that block acetylcholine, a nervous system neurotransmitter, have previously been implicated as a potential cause of cognitive impairment, by us and by other researchers,” said lead researcher, Dr. Noll Campbell, IU Center for Aging Research and Regenstrief Institute investigator. “This is the first study to calculate cumulative anticholinergic burden and determine that as burden increases, so does healthcare utilization in the U.S. — both outpatient and inpatient.”

Campbell and his colleagues found that daily use of a drug with mild anticholinergic properties for one year, increased a patient’s chances of being admitted to the hospital by 11 percent. Anticholinergic drugs used to treat heart conditions, such as hypertension, are classified into the mild group.

Taking a strong anticholinergic drugs – such as a sleeping pill – on a daily basis, increased the likelihood of inpatient admission by 33 percent. These findings are just the latest in a decade’s worth of patient safety studies of anticholinergic medications, conducted at the IU Center for Aging Research.

“As baby boomers age and the number of older adults increases, it is especially important to recognize the negative impact of anticholinergic medications on the aging brain and healthcare delivery cost,” said Dr. Malaz Boustani, Chief Innovation and Implementation Officer of IU Center for Health Innovation and Implementation Science. “There is a powerful association between these harmful medications and potentially avoidable cognitive impairment and increased visits to the doctor, the ER and the hospital.”

Campbell advices patients currently taking anticholinergic drugs to talk to their healthcare providers about alternative medications. “This new study provides stronger motivation to design and conduct de-prescribing studies to determine safe ways to take individuals off anticholinergic medications in the interests of preserving brain health and decreasing healthcare utilization rates and their potential costs,” said Campbell.