Analysis of high potency anticholinergic prescribing in Scottish nursing home patients

Purpose: The aim of this study was to compare the use of two or more high-potency anticholinergic (HPA) medications between patients 65 years and older in nursing homes and in the greater community using prescribing data. Methods: This secondary data analysis of the NHS Scotland PIS databased used prescription data from a nationally representative patient-level database. Patients were included were ≥65 years old, received ≥2HPA prescriptions from 2011Q2-2012Q1(11/12), 2016Q1-2017Q2(16/17), 2018Q2-2017Q1(18/19). The principle endpoint of this study was to assess for a change in patient’s relative risk of receiving ≥2HPA prescriptions. Results: 29,301 patients were identified. From 11/12 to 16/17 all community ≥65 years of age, and nursing home patients 65-74, 75-84 showed a relative risk reduction. 16/17 to 18/19, community patients 65-74 years and ≥85 no significant change in relative risk and 75-84 showed a relative risk increase. 16/17 to 18/19 nursing home patients 65-74 relative risk reduction and 75-84 no significant change. 16/17 to 18/19 nursing home patients aged ≥85 experienced a relative risk increase. Conclusion: Nursing home patients ≥85 years in 2018/2019 showed an increase in relative risk from patients in 2016/17, this group may still be at risk for the high anticholinergic burden