Association between anticholinergic burden and hospital readmission in older patients: a prospective analysis

ABSTRACT

Objective

Despite known adverse effects of anticholinergic (AC) medication, little work has been devoted to the impact of high anticholinergic burden on the rate of hospital readmission. The purpose of this study was to analyze prospectively the link between high AC burden and the rate of all-cause thirty-day hospital readmission in older people.

Study design

This was a prospective non-interventional study conducted from January to August 2019 in one acute-care geriatric ward. All hospital stays of patients aged at least 75 years who were discharged to their home were included in the analysis. AC burden was determined from discharge prescriptions using the Anticholinergic Drug Scale (ADS) and the Anticholinergic Risk Scale (ARS), and defined as high if ≥3.

Results

The analysis concerned 350 hospital stays. Median patient age was 88 years (interquartile interval 84–91). In a multivariate analysis, the risk of hospital readmission within 30 days was not increased for patients with high AC burden (ADS≥3): odds ratio 1.16 [95% confidence interval 0.56–2.37], compared to a patient whose anticholinergic burden was not high.

Conclusion

Unlike retrospective studies on this issue, the findings of our prospective analysis do not support a higher risk of hospital admission within 30 days for older people with high AC burden as assessed from their discharge prescriptions.

KEYWORDS:

• Hospital readmission
• older patients
• anticholinergic burden
• anticholinergic drug scale
• anticholinergic risk scale

Acknowledgments

The authors would like to thank all the individuals from the Delegation for Clinical Research and Innovation (Lille Catholic hospitals, Biostatistics Department), especially Stéphane Verdun for his important help at the beginning of this work.

Supplementary material

Supplemental data for this article can be accessed here.

Declaration of interest

No potential conflict of interest was reported by the authors.

Declaration of financial/other relationships

The authors report no conflicts with any product mentioned or concept discussed in this article.

Review disclosure

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

There was no funding received for this article.