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

An 8-week, parallel-arm, randomized trial was conducted to evaluate a targeted patient-centered pharmacist–physician team medication therapy management (MTM) intervention to improve anticholinergic medication appropriateness and reduce the use of inappropriate anticholinergic medications in older patients. Participants were randomized to intervention or control group. The intervention group received a medication review and recommendations for discontinuation or replacement of anticholinergic medications. Outcomes included changes in medication appropriateness index (MAI) and anticholinergic drug scale (ADS) scores.

To investigate whether a targeted multidisciplinary team intervention would be successful at reducing inappropriate anticholinergic medication use in older patients enrolled in a cohort at the Alzheimer's Disease Center at University of Kentucky.

Targeted MTM intervention involving pharmacist–clinician team reviewing medications and recommending discontinuation or replacement of anticholinergic medications.

Clinical pharmacists and clinicians at the University of Kentucky Alzheimer's Disease Center

Patients aged 65 and older, enrolled in the Alzheimer's Disease Center cohort, taking at least one anticholinergic medication, with Clinical Dementia Rating (CDR) < 2, and not living in long-term care.

Changes in medication appropriateness index (MAI), anticholinergic drug scale (ADS) score, number of anticholinergic drugs, and perceived health status using SF-36.