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@ARTICLE{Lepenies:282542,
      author       = {Lepenies, Laura K. and Seidling, Hanna M. and Pabst,
                      Alexander and Luppa, Melanie and Döhring, Juliane and
                      Williamson, Martin and Frese, Thomas and Gensichen, Jochen
                      and Hoffmann, Wolfgang and Kaduszkiewicz, Hanna and König,
                      Hans-Helmut and Thyrian, Jochen René and Wiese, Birgitt and
                      Riedel-Heller, Steffi G. and Czock, David},
      title        = {{D}eprescribing drugs with anticholinergic effects in older
                      patients with increased risk of dementia in the
                      multicomponent intervention study {A}ge{W}ell.de},
      journal      = {British journal of clinical pharmacology},
      volume       = {91},
      number       = {12},
      issn         = {0306-5251},
      address      = {Oxford},
      publisher    = {Wiley-Blackwell},
      reportid     = {DZNE-2025-01305},
      pages        = {3489 - 3500},
      year         = {2025},
      abstract     = {AimDrugs with anticholinergic effects are often considered
                      as potentially inappropriate medications, especially for
                      older patients, and deprescribing such drugs may improve
                      cognitive function. The aim was to investigate the
                      effectiveness of counselling on drug risks as part of a
                      multimodal intervention to prevent cognitive
                      decline.MethodsThe AgeWell.de study, a multi-centre,
                      cluster-randomized controlled study, was conducted in 123
                      German general practices between June 2018 and January 2022.
                      The study included a multicomponent intervention programme
                      for patients at increased risk of dementia, delivered over a
                      2-year period. As part of the medication optimisation
                      intervention, patient data and medication records were
                      screened to identify medication risks and provide
                      recommendations to general practitioners.ResultsIn total,
                      808 patients with complete data were included in the present
                      analysis (intervention group = 374, control
                      group = 434). At baseline, 132 $(16.8\%)$ patients had
                      at least one anticholinergic prescription. After 2 years,
                      approximately one-third of these patients no longer received
                      drugs with anticholinergic effects. There were no
                      significant differences between the intervention and control
                      groups, with $67.6\%$ and $72.1\%,$ respectively, continuing
                      to take drugs with anticholinergic effects (P = 0.57).
                      Patients reported anticholinergic symptoms more frequently
                      when taking any medication $(5.0\%$ vs $33.8\%),$ and even
                      more so when taking drugs with anticholinergic effects
                      $(56.1\%).$ Deprescribing of all drugs with anticholinergic
                      effects was non-significantly higher in patients who
                      reported at least one anticholinergic symptom compared to
                      patients without any anticholinergic symptoms $(58.6\%$ vs
                      $54.1\%).ConclusionThe$ medication optimisation intervention
                      did not entail significant differences in anticholinergic
                      deprescribing between the groups.},
      cin          = {AG Thyrian / AG Hoffmann},
      ddc          = {610},
      cid          = {I:(DE-2719)1510800 / I:(DE-2719)1510600},
      pnm          = {353 - Clinical and Health Care Research (POF4-353)},
      pid          = {G:(DE-HGF)POF4-353},
      typ          = {PUB:(DE-HGF)16},
      doi          = {10.1002/bcp.70194},
      url          = {https://pub.dzne.de/record/282542},
}