Anticholinergic burden assessed using general practice electronic records

Aim: To determine the anticholinergic burden (ACB) of an Australian primary care population. Method: A cross-sectional study was undertaken of medication data from 11 general practices. Participants were active patients aged 65 years and over seen at least 3 times in the last 2 years (n = 4853). The ACB score was calculated based on a UK peer-reviewed scoring system (Fox) and a modified scale (Fox-plus) that included medications not present in the Fox scale. The main outcome measure was total ACB from prescribed medications. Results: A Fox ACB score ≥ 4 is associated with increased risk of morbidity and mortality, 249 (9%) females, 130 (6%) males and 379 (8%) overall fell in this category. Applying the Fox-plus ACB scale, 983 (36%) females, 630 (30%) males and 1613 (33%) overall fell in this category. Conclusion: A large proportion of the elderly population may have cognitive impairment because of their therapy. Alternative medications or strategies are needed to maintain therapeutic benefits with a low ACB.