(P-504) Association Between Anticholinergic Burden of Medications and Emergency Care in the Elderly Assisted in the Brazilian Prymary Care Setting

Background: Anticholinergic drugs can reduce physical and cognitive function, especially in the older population due to their reduced acetylcholine physiological reserve. Since these effects are dose-related and cumulative, it’s critical to evaluate this population's exposure to this type of drug and assess its influence on their health status.

Objectives: Evaluate the association between the anticholinergic burden of medications (ABM) and the need for emergency care in the elderly assisted in Primary Health Care (PHC) in Sorocaba, SP.

Objectives: Evaluate the association between the anticholinergic burden of medications (ABM) and the need for emergency care in the elderly assisted in Primary Health Care (PHC) facility in Sorocaba, SP, Brazil.

Methods: A cross-sectional study involving elderly patients (age ≥65 years) assisted in PHC facility Maria do Carmo between January and March of 2019. Data was collected through interviews with the elderly and/or caregivers. ABM was assessed using the Brazilian anticholinergic activity drug scale and dichotomized into 0-1 and >1. Emergency care was evaluated through the question “In the last 12 months, how many times have you been in an emergency room without being hospitalized?”. Poisson regression was used to evaluate the association between ABM and emergency care, adjusted for confounders (sex, age, ethnicity, falls, and polypharmacy).

Results: Of 125 elders interviewed, 74 (59.2%) were women; median age 72 (65-95), with <75 years comprehending 84 (68.3%); 50 (40.0%) who had fell in the last 12 months; median ABM 1 (0-7) and mean ABM 1.1 (SD±1.54), of which 27 (22.0%) had ABM >1; and 65 (52.0%) used at least one anticholinergic drug from a total of 92 identified. The most used drugs were Atenolol (n=15; 12.0%), Furosemide (n=8; 6.4%) and Captopril (n=7; 5.6%). The association between ABM>1 and emergency care≥2 in the last 12 months was significant (p=0.016; PR=3.4; CI95%=1.27-9.02), even after adjusting for confounders.

Conclusions: Even in a small sample, the association was significant, highlighting the impact of ABM in the health care service of the elderly and the need for more studies with bigger sample sizes.