Falls and bone fractures are important causes of morbidity and mortality in the elderly.

A new study published in PLoS One aimed to identify the degree of consistency between the anticholinergic scales used for patients diagnosed with fractures.

This analytical agreement study was conducted among 220 patients diagnosed with vertebral and nonvertebral fractures in Colombia. The mean age of the participants was 75.3±10.3 years and 68.2% were women. The quadratic-weighted kappa coefficient was used to identify the consistency between the Anticholinergic Drug Scale-ADS, Anticholinergic Cognitive Burden Scale-ACB and Anticholinergic Risk Scale-ARS, in assessing the prescriptions of fracture patients during the month prior to fracture, during their stay as an inpatient and at discharge, according to Landis criteria.

The ACB scale identified the highest anticholinergic burden in prescriptions made on the month before the fracture, while the highest agreement was between ACB and ADS. During hospitalization and at discharge, the cholinergic antagonists were best identified with ADS, with the best agreement between ACB and ARS. Meanwhile, 64.1% of hospitalized patients and in 61.4% of patients discharged were prescribed tramadol.

In inference, it was stated that the scales evaluated showed marked discrepancies, with highly variable frequencies of anticholinergic drugs identified at the different prescription times and low agreement among them. Therefore, these scales are not interchangeable in patients with bone fractures.

Source: PLoS One. 2020 Feb 24;15(2):e0228532. doi: 10.1371/journal.pone.0228532.