Premium
Development of an Anticholinergic Burden Scale specific for Korean older adults
Author(s) -
Jun Kwanghee,
Hwang Sunghee,
Ah YoungMi,
Suh Yewon,
Lee JuYeun
Publication year - 2019
Publication title -
geriatrics and gerontology international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.823
H-Index - 57
eISSN - 1447-0594
pISSN - 1444-1586
DOI - 10.1111/ggi.13680
Subject(s) - anticholinergic , medicine , delphi method , polypharmacy , anticholinergic agents , delphi , deprescribing , scale (ratio) , psychiatry , intensive care medicine , anesthesia , statistics , physics , mathematics , quantum mechanics , computer science , operating system
Aim The aim of this study was to develop the Korean Anticholinergic Burden Scale through assessment of previously developed tools, a literature review and a modified Delphi process. Methods We carried out a systematic review to identify previously published anticholinergic burden tools. A composite medication list was made by extracting medications and their quantitative grading from the existing tools, after excluding the medications not distributed in Korea and topical agents. We also added medications available in Korea that had not been rated. For medications with conflicting anticholinergic scores or no anticholinergic score, we determined the final score from 0 (“no anticholinergic effect”) to 3 (“strong anticholinergic effect”) with a literature review and expert consensus through a two‐round Delphi process. Results A composite list of 655 medications with anticholinergic scores was extracted from 10 existing tools. A total of 38 medications available in Korea were added to the list. A total of 494 medications were deemed suitable for a Korean‐specific scale. We confirmed the anticholinergic scores of 352 medications from existing scales, and 142 underwent the Delphi process. The final scores graded by experts showed high reliability among experts with an intra‐class correlation of 0.98 (95% confidence interval 0.97–0.98). Finally, 56 medications were categorized as strong anticholinergics, 23 as moderate, 59 as weak and 356 as having no anticholinergic activity. Conclusions This newly created consensus‐driven anticholinergic burden scale designed specifically for the Korean healthcare system might be a practical tool for assessing anticholinergic burden in older adults with polypharmacy in routine medication reviews and in research. Geriatr Gerontol Int 2019; 19: 628–634 .