The usage of anticholinergic medications in a low- and middle-income country: a longitudinal comparison of 2013-15 and 2020-22 datasets

Xu XJ 1 , Myint PK 2 , Lee SWH 3 , Ramasamy K 4 , Lim SM 4 , Majeed ABA 4 Show all authors , Wong YY 5 , Mat S 6 , Saedon NI 1 , Mahadzir H 7 , Hasmukharay K 8 , Tan MP 9

Affiliations 

  • 1 Ageing and Age-Associated Disorders Research Group, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
  • 2 Ageing Clinical & Experimental Research (ACER) Group, Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, UK
  • 3 School of Pharmacy, Monash University Malaysia, Bandar Sunway, Selangor, Malaysia
  • 4 Faculty of Pharmacy, Universiti Teknologi MARA(UiTM) Cawangan Selangor, Kampus Puncak Alam, 42300, Bandar Puncak Alam, Selangor Darul Ehsan, Malaysia
  • 5 Faculty of Pharmacy, Universiti Teknologi MARA (UiTM) Cawangan Pulau Pinang, Bertam Campus,, Permatang Pauh, Pulau Pinang, Malaysia
  • 6 Physiotherapy Programme, Faculty of Health Sciences, Center for Healthy Ageing and Wellness, Universiti Kebangsaan Malaysia, Bangi, Malaysia
  • 7 Geriatric Unit, Department of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
  • 8 Divison of Geriatric Medicine, Department of Medicine, University of Malaya Medical Center, Kuala Lumpur, Malaysia
  • 9 Ageing and Age-Associated Disorders Research Group, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia. mptan@ummc.edu.my
Int J Clin Pharm, 2024 Dec;46(6):1453-1463.
PMID: 39264491 DOI: 10.1007/s11096-024-01791-1

Abstract

BACKGROUND: While the effects of anticholinergic drug use have been increasingly highlighted, trends in anticholinergic use remain poorly understood.

AIM: To determine the changes in frequency and pattern of anticholinergic drug use within a low- and middle-income country.

METHOD: Comparisons were made between population-based datasets collected from Malaysian residents aged 55 years and older in 2013-15 and 2020-22. Anticholinergic exposure was determined using the anticholinergic cognitive burden (ACB) tool. Drugs with ACB were categorised according to the Anatomical Therapeutic Chemical (ATC) classification.

RESULTS: A total number of 5707 medications were recorded from the 1616 participants included in the 2013-15 dataset. A total number of 6175 medications were recorded from 2733 participants in 2020-22. Two hundred and ninety-three (18.1%) and 280 (10.2%) participants consumed ≥ 1 medication with ACB ≥ 1 in 2013-15 and 2020-22 respectively. The use of nervous system drugs with ACB had increased (27 (0.47%) versus 39 (0.63%). The use of ACB drugs in the cardiovascular (224 (3.9%) versus 215 (3.4%)) and alimentary tract and metabolism (30 (0.52%) versus 4 (0.06%)) classes had reduced over time. Participants in 2020-22 were significantly less likely than those in 2013-15 to have total ACB = 1 - 2 (odds ratio [95% confidence interval] = 0.473[0.385-0.581]) and ACB ≥ 3 (0.251[0.137 - 0.460]) compared to ACB = 0 after adjustment for potential confounders (p 

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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