한국임상약학회지 (Korean Journal of Clinical Pharmacy)

  • 제30권2호
  • /
  • Pages.113-119
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  • 2020
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  • 1226-6051(pISSN)
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  • 2508-786X(eISSN)
한국임상약학회 (Korean College Of Clinical Pharmacy)
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다학제 팀의료에 의한 노인의료센터 입원환자의 항콜린약물부담 감소효과 분석

Impacts of Pharmacist-involved Multidisciplinary Geriatric Team Services on Reducing Anticholinergic Burden

  • 이주혜 (분당서울대학교병원 약제부) ;
  • 박가영 (분당서울대학교병원 약제부) ;
  • 서예원 (분당서울대학교병원 약제부) ;
  • 이정화 (분당서울대학교병원 약제부) ;
  • 이은숙 (분당서울대학교병원 약제부) ;
  • 김은경 (서울대학교 약학대학) ;
  • 최정연 (분당서울대학교병원 노인병내과) ;
  • 김광일 (분당서울대학교병원 노인병내과) ;
  • 이주연 (서울대학교 약학대학)
  • Lee, Juhye (Department of Pharmacy, Seoul National University Bundang Hospital) ;
  • Park, Kayoung (Department of Pharmacy, Seoul National University Bundang Hospital) ;
  • Suh, Yewon (Department of Pharmacy, Seoul National University Bundang Hospital) ;
  • Lee, Junghwa (Department of Pharmacy, Seoul National University Bundang Hospital) ;
  • Lee, Eunsook (Department of Pharmacy, Seoul National University Bundang Hospital) ;
  • Lee, Euni (College of Pharmacy & Research Institute of Pharmaceutical Sciences, Seoul National University) ;
  • Choi, Jung-Yeon (Department of Internal Medicine, Seoul National University Bundang Hospital) ;
  • Kim, Kwang-Il (Department of Internal Medicine, Seoul National University Bundang Hospital) ;
  • Lee, Ju-Yeun (College of Pharmacy & Research Institute of Pharmaceutical Sciences, Seoul National University)
  • 투고 : 2020.03.14
  • 심사 : 2020.06.02
  • 발행 : 2020.06.30
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초록

Background: Reducing the total anticholinergic burden (AB) in older adults is recommended owing to the several peripheral and central adverse effects. This study aimed to identify the AB status of patients admitted to geriatric centers for assessing the influence of the pharmacist-involved multidisciplinary geriatric team care on reducing the AB. Methods: We retrospectively reviewed the medical records of 328 older patients hospitalized in geriatric centers from July 1, 2018 to June 30, 2019, who received comprehensive geriatric assessment and pharmaceutical interventions from a multidisciplinary geriatric team. We measured the total AB scores for the medications at the time of admission and upon hospital discharge using the Korean Anticholinergic Burden Scale (KABS). The pre-admission factors associated with high AB (KABS score ≥3) at the time of admission were identified. Results: The proportion of patients with high AB significantly decreased from 41.8% (136/328) at the time of admission to 25.0% (82/328) on discharge (p<0.001). The pre-admission AB of patients transferred from skilled nursing facilities (odds ratio[OR]: 2.85, 95% CI: 1.26-3.75), taking more than 10 medications (OR: 3.70, 95% CI: 1.55-8.82), suffering from delirium (OR: 2.80, 95% CI: 1.04-7.50), or depression (OR: 2.78, 95% CI: 1.04-7.41) were significantly high. Antipsychotics were the most frequent classes of drugs that contributed to the total KABS score at the time of admission, followed by antihistamines. Conclusions: This study demonstrated that the multidisciplinary teams for geriatric care are effective at reducing AB in older adults. The factors associated with high AB should be considered when targeting pharmaceutical care in geriatric individuals.

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참고문헌

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