Deprescribing and Minimizing Use of Anticholinergic Medications

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Background

Background
The global ageing population is increasingly challenged by multi-morbidity resulting in polypharmacy. Over the last two decades, medications with anticholinergic properties have been particularly strongly associated with a wide range of adverse outcomes. However, anticholinergic medications have a broad range of indications and continue to be widely prescribed. The present challenge is to consider how best to minimize harm from this group of drugs. There is a growing evidence base for the safety and efficacy of deprescribing approaches. However, deprescribing approaches to anticholinergic therapy specifically remains relatively understudied. Although there are now multiple tools to measure the extent of anticholinergic prescribing, it is unclear what tool performs best. Moreover, there is currently no simple or reliable way for patients to know if their medications have anticholinergic effects. There are significant evidence gaps around how best to optimize use of these medications, how to usefully involve key stakeholders in decisions around their medications or what deprescribing interventions should look like. The effects of deprescribing interventions on key outcomes of patient safety and experience are unknown. Nevertheless, public and clinician awareness of the dangers of anticholinergic therapy is growing and this is reflected in the increasing amounts of research on anticholinergic medications. It is likely the next decade will see major new research filling much of the evidence gap and significant improvements in the safety of prescribing medications with anticholinergic effects.

Goal
This Research Topic will present the state of the art in best practice of responsibly prescribing and deprescribing anticholinergic therapy.

Scope
Submitted manuscripts should contribute to our knowledge of best practice in prescribing and deprescribing anticholinergic therapy. Articles that mostly address only deprescribing or only anticholinergic therapy will be considered if they are novel and have clear potential to significantly add to the evidence base around starting, continuing or stopping anticholinergic drugs. For example, a trial of a deprescribing intervention that is not specific to anticholinergics could still be considered if the key messages could reasonably be extrapolated to anticholinergic therapy. Similarly, articles that provide new knowledge on anticholinergic therapy would be appropriate if they impacted on the clinical practice or research on anticholinergic prescribing, such as a study comparing anticholinergic risk scales on outcomes likely to be used in deprescribing trials.

Details for Authors
We welcome submissions of Original Research studies, Systematic Reviews, authoritative narrative Reviews, Perspective Commentaries and relevant clinical Case Reports. Protocols for relevant randomized controlled trials or scientific studies will be also considered. Authors are encouraged to contact the editorial team if they are uncertain about the suitability of their work for this collection.

Keywords: antimuscarinic, deprescribing, medications, polypharmacy, Anticholinergic

Important note: All contributions to this Research Topic must be within the scope of the section and journal to which they are submitted, as defined in their mission statements. Frontiers reserves the right to guide an out-of-scope manuscript to a more suitable section or journal at any stage of peer review.

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