Aims: Older adults experience high rates of polypharmacy,defined as concurrent use of five or more medications.This raises the risk of potentially inappropriate prescriptions (PIPs) and an anticholinergic burden (ACB) which can negatively impact health outcomes.This study aimed to identify prevalence and types of PIPs and measure ACB scores in a population of community-dwelling older adults receiving in-home rehabilitation.Additionally,it sought to explore demographic and clinical factors associated with PIPs and ACB scores.
Methods: A cross-sectional study was conducted involving 95 patients from a Rehabilitation-In-The-Home (RITH) service in Western Australia.Data were collected from patient medical records including demographic,comorbidity,functional status,and medication lists.PIPs were assessed using the Beers-2023 and STOPP/START-V3 criteria (Screening-Tool of Older People’s Prescriptions/Screening-Tool to Alert to Right Treatment).Anticholinergic burden was calculated using the ACB score.Descriptive statistics were used for each variable on its own.Associations between PIPs and ACB score,and demographic and clinical factors were tested using Chi-Square and one-way ANOVA.
Results: The prevalence of potentially inappropriate medications (PIMs) was 65% using Beers criteria and 71% using STOPP criteria.Potential prescribing omissions (PPOs) were identified in 44% of patients.A total of 35% of patients had a high ACB score.The number of medications was the most consistently significant clinical factor associated with PIMs,PPOs and ACB score.
Conclusions: This exploratory study revealed a high prevalence of PIPs and significant ACB among patients undergoing RITH.The findings underscore the need for screening methods to identify patients for comprehensive medication review to ensure appropriateness of prescriptions to improve outcomes for older adults in a community rehabilitation setting.