Drug Burden Index in older adults: theoretical and practical issues

Abstract

Lisa Kouladjian,1 Danijela Gnjidic,1,2 Timothy F Chen,2 Arduino A Mangoni,3 Sarah N Hilmer1 1Sydney Medical School, University of Sydney, Kolling Institute of Medical Research and Departments of Clinical Pharmacology and Aged Care, Royal North Shore Hospital, 2Faculty of Pharmacy, University of Sydney, Sydney, NSW, 3Department of Clinical Pharmacology, School of Medicine, Flinders University and Flinders Medical Centre, Bedford Park, SA, Australia Abstract: Anticholinergic and sedative medications are commonly used in older adults and are associated with adverse clinical outcomes. The Drug Burden Index was developed to measure the cumulative exposure to these medications in older adults and its impact on physical and cognitive function. This narrative review discusses the research and clinical applications of the Drug Burden Index, and its advantages and limitations, compared with other pharmacologically developed measures of high-risk prescribing. Keywords: Drug Burden Index, anticholinergics, sedative medications, high-risk prescribing, older adults, pharmacological risk assessment tools, deprescribing

Keywords

• Drug Burden Index
• anticholinergic and sedative medications
• high-risk prescribing
• older adults
• pharmacological risk assessment tools
• potentially inappropriate medications