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Optimizing medication appropriateness in older adults: a randomized clinical interventional trial to decrease anticholinergic burden

Overview of attention for article published in Alzheimer's Research & Therapy, May 2017
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  • In the top 25% of all research outputs scored by Altmetric
  • High Attention Score compared to outputs of the same age (86th percentile)

Mentioned by

news
1 news outlet
twitter
8 tweeters

Citations

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29 Dimensions

Readers on

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144 Mendeley
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Title
Optimizing medication appropriateness in older adults: a randomized clinical interventional trial to decrease anticholinergic burden
Published in
Alzheimer's Research & Therapy, May 2017
DOI 10.1186/s13195-017-0263-9
Pubmed ID
Authors

Daniela C. Moga, Erin L. Abner, Dorinda N. Rigsby, Lynne Eckmann, Mark Huffmyer, Richard R. Murphy, Beth B. Coy, Gregory A. Jicha

Abstract

The complexity of medication therapy in older adults with multiple comorbidities often leads to inappropriate prescribing. Drugs with anticholinergic properties are of particular interest because many are not recognized for this property; their use may lead to increased anticholinergic burden resulting in significant health risks, as well as negatively impacting cognition. Medication therapy management (MTM) interventions showed promise in addressing inappropriate medication use, but the effectiveness of targeted multidisciplinary team interventions addressing anticholinergic medications in older populations is yet to be determined. We conducted an 8-week, parallel-arm, randomized trial to evaluate whether a targeted patient-centered pharmacist-physician team MTM intervention ("targeted MTM intervention") reduced the use of inappropriate anticholinergic medications in older patients enrolled in a longitudinal cohort at University of Kentucky's Alzheimer's Disease Center. Study outcomes included changes in the medication appropriateness index (MAI) targeting anticholinergic medications and in the anticholinergic drug scale (ADS) score from baseline to the end of study. Between October 1, 2014 and September 30, 2015 we enrolled and randomized 50 participants taking at least one medication with anticholinergic properties. Of these, 35 (70%) were women, 45 (90%) were white, and 33 (66%) were cognitively intact (clinical dementia rating [CDR] = 0); mean age was 77.7 ± 6.6 years. At baseline, the mean MAI was 12.6 ± 6.3; 25 (50%) of the participants used two or more anticholinergics, and the mean ADS score was 2.8 ± 1.6. After randomization, although no statistically significant difference was noted between groups, we identified a potentially meaningful imbalance as the intervention group had more participants with intact cognition, and thus included CDR in all of the analyses. The targeted MTM intervention resulted in statistically significant CDR adjusted differences between groups with regard to improved MAI (change score of 3.6 (1.1) for the MTM group as compared with 1.0 (0.9) for the control group, p = 0.04) and ADS (change score of 1.0 (0.3) for the MTM group as compared with 0.2 (0.3) for the control group, p = 0.03). Our targeted MTM intervention resulted in improvement in anticholinergic medication appropriateness and reduced the use of inappropriate anticholinergic medications in older patients. Our results show promise in an area of great importance to ensure optimum outcomes for medications used in older adults. ClinicalTrials.gov NCT02172612 . Registered 20 June 2014.

Twitter Demographics

The data shown below were collected from the profiles of 8 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 144 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 144 100%

Demographic breakdown

Readers by professional status Count As %
Student > Master 26 18%
Student > Ph. D. Student 17 12%
Researcher 16 11%
Student > Bachelor 12 8%
Other 11 8%
Other 29 20%
Unknown 33 23%
Readers by discipline Count As %
Medicine and Dentistry 29 20%
Pharmacology, Toxicology and Pharmaceutical Science 29 20%
Nursing and Health Professions 17 12%
Psychology 6 4%
Unspecified 4 3%
Other 16 11%
Unknown 43 30%

Attention Score in Context

This research output has an Altmetric Attention Score of 14. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 08 September 2019.
All research outputs
#1,762,277
of 18,920,065 outputs
Outputs from Alzheimer's Research & Therapy
#380
of 974 outputs
Outputs of similar age
#38,450
of 280,148 outputs
Outputs of similar age from Alzheimer's Research & Therapy
#1
of 1 outputs
Altmetric has tracked 18,920,065 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 90th percentile: it's in the top 10% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 974 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 23.0. This one has gotten more attention than average, scoring higher than 61% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 280,148 tracked outputs that were published within six weeks on either side of this one in any source. This one has done well, scoring higher than 86% of its contemporaries.
We're also able to compare this research output to 1 others from the same source and published within six weeks on either side of this one. This one has scored higher than all of them