reDucing Anticholinergic burRen Treatments (DART)
Research type
Research Study
Full title
The feasibility and acceptability of a collaborative deprescribing intervention to reduce anticholinergic burden among hospitalised older patients
IRAS ID
351020
Contact name
Kinda Ibrahim
Contact email
Sponsor organisation
University Hospital Southampton
Duration of Study in the UK
0 years, 11 months, 31 days
Research summary
It is estimated that over one third of all older adults are prescribed medication which are known to have “anticholinergic” side effects. These anticholinergic side effects can include an increased risk of falls, delirium, and memory problems. People who have a high number of anticholinergic medications have an increased risk of these side effects. This can be measured as their anticholinergic burden (ACB). Several tools have been developed to assess the ACB score, by checking a person’s medication list, with the aim of reducing these medications where possible (deprescribing).
A computer software already available in one large hospital can identify patients with high anticholinergic burden and calculate the total ACB score for patients instantly using their electronic medication list. It can also list the individual anticholinergic medications contributing to that score. In this project, we plan to understand how this tool can be used by clinicians in older persons wards to reduce the number of anticholinergic medications prescribed.
First, pharmacists will check weekly using the computerised program how many patients have high ACB scores. Then they would highlight in patients’ medical notes the list of medications with high anticholinergic effects using a sticker note. The doctor looking after the patient then sees the note which would prompt him/her to review medications and decide whether it is possible to stop the anticholinergic drug, reduce the dose or switch to a safer drug.
We will test this intervention among 50 patients admitted to older people wards in this hospital. We will collect information from patient before and after the intervention including number and type of medications prescribed, quality of life, and cognition. We will also talk to staff and patients to understand their views about the intervention, any challenges, and how to improve the process.
Two patient and public contributors have been actively involved in developing this research proposal. They represent a carer of person with dementia and an older person with comorbidity and polypharmacy, and both have lived experience of managing polypharmacy following hospital admission. They will continue to provide input on study procedures and materials and contribute to plans for sharing the findings.
REC name
London - Central Research Ethics Committee
REC reference
25/LO/0171
Date of REC Opinion
26 Mar 2025
REC opinion
Further Information Favourable Opinion