Anticholingeric burden screening and reduction for older adults in long-term care
| dc.contributor.advisor | Garcia, Theresa | |
| dc.contributor.author | Arredondo, Derek | |
| dc.contributor.committeeMember | Baldwin, Sara | |
| dc.contributor.committeeMember | DeGrande, Heather | |
| dc.date.accessioned | 2020-05-02T19:07:32Z | |
| dc.date.available | 2020-05-02T19:07:32Z | |
| dc.date.issued | 2019-08 | |
| dc.description.abstract | Anticholinergic (ACH) medication use amongst older adults has been associated with cognitive decline, development of dementia, counteraction of cholinergic dementia treatments, numerous adverse effects and subsequent prescribing cascades. Older adults in long-term care facilities (LTCF) are exceptionally vulnerable to these adverse effects. This quality improvement project implemented an evidence-based ACH cognitive burden screening and reduction program for adults aged 60 and older (N=31) in a south Texas LTCF to maximize cognitive function. Based on ACH medication screenings, reduction recommendations were made to prescribers for 19 residents. A three-group comparative design was used. The 3 groups included: those without recommended ACH reductions (n=12), those with recommendations for reduction which were approved by their prescribers (n=11) and those with recommendations which were not approved (n=8). Cognitive function was measured with the Short-Blessed Test (SBT) and ACH use with the Anticholinergic Cognitive Burden (ACB) scale. The group with approved reduction recommendations had a decreased mean (M ) ACB score (0.73 points lower, p=0.233) and a lower M SBT score (1.82 points lower, p=0.051) at 60-days post-intervention when compared to pre-intervention. Overall, the 31 participants had a significant decrease in M SBT (by 1.06, p=0.026) and a decrease in M ACB (by 0.23, p=0.422) in the same period. Those without any ACH reduction recommendations (n=12), were found to have a significantly increased M ACB, from 0.42 to 1.08 at the conclusion (p=0.013). The application of an evidence-based ACB screening and reduction program decreased ACB and was associated with clinically improved cognitive function in the residents of this facility. These findings were clinically significant and may also provide useful clinical outcome data to support research into, and improvement of, prescribing practices in LTCFs. | en_US |
| dc.description.college | College of Nursing and Health Sciences | en_US |
| dc.description.department | Nursing Practice | en_US |
| dc.format.extent | 48 pages | en_US |
| dc.identifier.uri | https://hdl.handle.net/1969.6/87842 | |
| dc.language.iso | en_US | en_US |
| dc.rights | Attribution-NonCommercial-NoDerivs 3.0 United States | * |
| dc.rights | This material is made available for use in research, teaching, and private study, pursuant to U.S. Copyright law. The user assumes full responsibility for any use of the materials, including but not limited to, infringement of copyright and publication rights of reproduced materials. Any materials used should be fully credited with its source. All rights are reserved and retained regardless of current or future development or laws that may apply to fair use standards. Permission for publication of this material, in part or in full, must be secured with the author and/or publisher. | en_US |
| dc.rights.uri | http://creativecommons.org/licenses/by-nc-nd/3.0/us/ | * |
| dc.subject | ACB | en_US |
| dc.subject | anticholinergic burden | en_US |
| dc.subject | anticolinergics | en_US |
| dc.subject | cognitive function | en_US |
| dc.subject | dementia | en_US |
| dc.subject | elderly | en_US |
| dc.title | Anticholingeric burden screening and reduction for older adults in long-term care | en_US |
| dc.type | Text | en_US |
| dc.type.genre | Dissertation | en_US |
| dcterms.type | Text | |
| dcterms.type | Text | |
| thesis.degree.discipline | Nursing Practice DNP | en_US |
| thesis.degree.grantor | Texas A & M University--Corpus Christi | en_US |
| thesis.degree.level | Doctoral | en_US |
| thesis.degree.name | Doctor of Nursing Practice | en_US |