Year of Publication

2020

College

Public Health

Degree Name

Master of Public Health (M.P.H.)

Committee Chair

Dr. Ty Borders

Committee Member

Dr. Rick Ingram

Committee Member

Dr. Karen Blumenschein

Abstract

Purpose: The aim of this study was to compare the use of two or more high-potency anticholinergic (HPA) medications between patients 65 years and older in nursing homes and in the greater community using prescribing data. Methods: This secondary data analysis of the NHS Scotland PIS databased used prescription data from a nationally representative patient-level database. Patients were included were ≥65 years old, received ≥2HPA prescriptions from 2011Q2-2012Q1(11/12), 2016Q1-2017Q2(16/17), 2018Q2-2017Q1(18/19). The principle endpoint of this study was to assess for a change in patient’s relative risk of receiving ≥2HPA prescriptions. Results: 29,301 patients were identified. From 11/12 to 16/17 all community ≥65 years of age, and nursing home patients 65-74, 75-84 showed a relative risk reduction. 16/17 to 18/19, community patients 65-74 years and ≥85 no significant change in relative risk and 75-84 showed a relative risk increase. 16/17 to 18/19 nursing home patients 65-74 relative risk reduction and 75-84 no significant change. 16/17 to 18/19 nursing home patients aged ≥85 experienced a relative risk increase. Conclusion: Nursing home patients ≥85 years in 2018/2019 showed an increase in relative risk from patients in 2016/17, this group may still be at risk for the high anticholinergic burden.

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