Basic & clinical pharmacology & toxicology · 2026
The Feasibility and Acceptability of a Collaborative Deprescribing Intervention to Reduce Anticholinergic Burden Among Hospitalised Older Patients.
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Ibrahim Kinda, Radcliffe Eloise, Hewertson Edward, Bates Andrew, Fox Andy, Smith Emily, Mckenzie Cathrine, Jones Liam, Mckelvie Sara, Kandala Ngianga Ii, McCloskey Sara, Sach Tracey, Lim Stephen
Аннотация
INTRODUCTION: 37%-48% of older patients receive anticholinergic medicines, increasing the risk for falls, delirium, dementia and death. Hospital admission may provide an opportunity for deprescribing to improve outcomes. This study evaluated the feasibility and acceptability of a digital tool to identify anticholinergic medicines and support deprescribing.
METHODS: A pre-post feasibility study was conducted (May-September 2025). Patients aged ≥ 75 with an ACB score of ≥ 3, screened using a digital tool, were recruited. The identified medications were highlighted to the clinical team to prompt a medication review (stop, reduce or switch). Primary outcomes were recruitment and retention. Secondary outcomes included medication and patients' outcomes, healthcare use and acceptability from qualitative interviews.
RESULTS: Recruitment was challenging; 65 out of 301 patients with ACB ≥ 3 (22%) were eligible, 21 participated, of which 15 (80%) completed follow-up. Mean age was 84.7 years, and intervention costs were £9.33 per patient. Interviews indicated technical and organisational challenges. Mean ACB scores were 3.85 (admission), 3.45 (discharge), 3.0 (1 month) and 3.44 (3 months), with slight changes in cognition and delirium but no changes in depressive symptoms or quality of life.
CONCLUSIONS: Although acceptable, recruitment and technical challenges limited feasibility. Findings should be interpreted cautiously due to the small sample size, and further refinement is needed before implementation.
METHODS: A pre-post feasibility study was conducted (May-September 2025). Patients aged ≥ 75 with an ACB score of ≥ 3, screened using a digital tool, were recruited. The identified medications were highlighted to the clinical team to prompt a medication review (stop, reduce or switch). Primary outcomes were recruitment and retention. Secondary outcomes included medication and patients' outcomes, healthcare use and acceptability from qualitative interviews.
RESULTS: Recruitment was challenging; 65 out of 301 patients with ACB ≥ 3 (22%) were eligible, 21 participated, of which 15 (80%) completed follow-up. Mean age was 84.7 years, and intervention costs were £9.33 per patient. Interviews indicated technical and organisational challenges. Mean ACB scores were 3.85 (admission), 3.45 (discharge), 3.0 (1 month) and 3.44 (3 months), with slight changes in cognition and delirium but no changes in depressive symptoms or quality of life.
CONCLUSIONS: Although acceptable, recruitment and technical challenges limited feasibility. Findings should be interpreted cautiously due to the small sample size, and further refinement is needed before implementation.