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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     = {Drugs 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.The 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.In 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
                      $54.1\%).The$ medication optimisation intervention did not
                      entail significant differences in anticholinergic
                      deprescribing between the groups.},
      keywords     = {Humans / Cholinergic Antagonists: adverse effects /
                      Cholinergic Antagonists: administration $\&$ dosage / Male /
                      Female / Dementia: prevention $\&$ control / Dementia:
                      chemically induced / Dementia: epidemiology / Aged /
                      Deprescriptions / Aged, 80 and over / Inappropriate
                      Prescribing: prevention $\&$ control / Germany / Counseling:
                      methods / General Practice / Cognitive Dysfunction:
                      prevention $\&$ control / Cognitive Dysfunction: chemically
                      induced / Risk Factors / anticholinergic drugs (Other) /
                      dementia (Other) / deprescribing (Other) / lifestyle
                      intervention (Other) / randomized controlled study (Other) /
                      Cholinergic Antagonists (NLM Chemicals)},
      cin          = {AG Hoffmann / AG Thyrian},
      ddc          = {610},
      cid          = {I:(DE-2719)1510600 / I:(DE-2719)1510800},
      pnm          = {353 - Clinical and Health Care Research (POF4-353)},
      pid          = {G:(DE-HGF)POF4-353},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:40817636},
      pmc          = {pmc:PMC12648363},
      doi          = {10.1002/bcp.70194},
      url          = {https://pub.dzne.de/record/282542},
}