Improving the safe use of medicines with anticholinergic effects for older people can have a positive impact on quality of life and reduce the risk of side effects.
For health professionals
Key points
- While medicines with anticholinergic effects are useful to treat many conditions, their broad range of actions on the central and peripheral nervous systems can result in unintended adverse effects.
- Cumulative anticholinergic burden may be caused by multiple medicines not typically thought of as having anticholinergic effects.
- Anticholinergic burden is associated with poor health outcomes, particularly for older people, including an increase in falls-related hospitalisation, the risk of dementia and mortality.
- A shared understanding of the patient’s personal goals and preferences may improve health outcomes, facilitate patient-centred medication management reviews and drive comprehensive care planning.
- Medication management reviews lead to healthier patients, improved compliance, empowerment and improved confidence to self-manage, and better use of medicines.
- Consider a patient-centred multidisciplinary approach to assessing, managing and reviewing anticholinergic burden, and optimise non-pharmacological options where possible.
Important but not always front of mind: anticholinergic burden
NPS MedicineWise medical advisor Dr Caroline West talks to our other medical adviser Dr Kate Annear about the cumulative effects of anticholinergic medicines.
Focus on anticholinergic burden
How much do you regard anticholinergic burden as an issue that needs your attention?
Identifying and managing medicines with anticholinergic effects can be challenging, as many are not thought of as having these effects.
GPs play a key role in the safe use of medicines with anticholinergic effects.
Clinical resources and tools
CPD options
- Educational visit for primary care: Anticholinergic burden: the unintended consequences for older people
- Educational visit for RACF: Anticholinergic burden: the unintended consequences for older people
Resources to use with your patients
- Choosing Wisely (English): Side effects from your medicines? 5 questions to ask (anticholinergic side effects)
- Factsheet (English): How a medicines review can help you get the most from your medicines
- Decision aid: Exploring my option: When my medicines may be causing side effects (anticholinergic side effects)
- Action plan: Planning for a change: When my medicines may be causing side effects (anticholinergic side effects)
Resources to use with your Aboriginal and Torres Strait Islander patients
At NPS MedicineWise, we acknowledge the Aboriginal and Torres Strait Islander peoples as the traditional owners of the lands across Australia. We pay our respects to their Elders past, present and emerging.
- Resources (coming soon)
Resources in community languages
NPS MedicineWise has developed resources in a range of languages.
Research and references
Choosing Wisely Australia
Choosing Wisely Australia helps healthcare providers and consumers have important conversations about improving the quality of healthcare by reducing unnecessary and sometimes harmful tests, treatments, and procedures.
5 questions to ask your doctor or other healthcare provider is a resource that can help patients ensure they end up with the right amount of care.
Reducing anticholinergic burden: Framework for action
This briefing paper provides key insights about anticholinergic burden, including the scale of the issue, clinical practice challenges and barriers to reducing anticholinergic burden, and current programs and activities that are addressing the problem.
The aim of the briefing paper is to build momentum for shared action to address anticholinergic burden.