Research and references

Reference

Summary

The Royal Australian College of General Practitioners (RACGP)

RACGP aged care clinical guide (Silver Book) 5th Edition

This clinical resource focuses on providing appropriate care for older people.

Part A. Deprescribing
This section provides guidance on:

• potential benefits and harms
• developing a deprescribing plan.

Part A. Medication management

Part A. Polypharmacy

Part A. Behavioural and psychological symptoms of dementia
This section provides guidance on:

• first-line non-pharmacological management
• pharmacological management.

Part A. Short-term pharmacotherapy management of severe BPSD
This section provides guidance on:

• first-line non-pharmacological management
• pharmacological management.

Part A. Pain
This section provides guidance on:

• tools for pain assessment
• pain management strategies.

Part A. Mental health
This section provides guidance on:

• diagnosis and management of depression
• diagnosis and management of anxiety disorder
• diagnosis and management of suicide
• diagnosis and management of bipolar disorder
• diagnosis and management of schizophrenia.

Part A. Falls
This section provides guidance on:

• falls risk assessments
• falls management.

Part A. Urinary incontinence

Kouladjian O’Donnell et al. 2017

Anticholinergic burden: considerations for older adults

This article provides health professionals with information about older-aged people and the pharmacology of medicines with anticholinergic effects. The definition, measurement and poor outcomes of anticholinergic burden are also discussed, and interventions to reduce anticholinergic burden, including deprescribing.

The authors of the article include Professor Sarah Hilmer and Dr Lisa Kouladjian O'Donnell.

Bell et al. 2021

Identifying anticholinergic burden in clinical practice

This article published by Prescriber, a UK-based publication, provides information for health professionals about medicines with anticholinergic effects, measurement scales for anticholinergic burden and clinical practice guidance for GPs and pharmacists.

Kalisch Ellet et al. 2014

Multiple anticholinergic medication use and risk of hospital admission for confusion or dementia

This cohort study of 36,015 Australian veterans identified an association between the use of multiple medicines with anticholinergic effects and the rate of hospitalisation due to confusion and dementia, with an IRR of:

• 1.17 for patients taking one medicine with anticholinergic effects
• 2.58 for patients taking two medicines with anticholinergic effects
• 3.87 for patients taking three or more medicines with anticholinergic effects.

Reference

Summary

Stewart et al. 2021

Barriers and facilitators to reducing anticholinergic burden: a qualitative systemic review

A systematic review of studies exploring barriers and facilitators to reducing anticholinergic burden in the Australian healthcare system.

It found that studies exploring patient and carer perspectives are currently absent but are required to ensure person-centred care and feasibility of future interventions.

Weir et al. 2020

Pharmacists’ and older adults’ perspectives on the benefits and barriers of Home Medicines Reviews – a qualitative study

This Australian study highlights the barriers to an effective Home Medicines Review (HMR), including gaps in inter-professional communication and factors relating to patient involvement, such as limited medicines understanding and health literacy.

White et al. 2012

Consumer perspectives of the Australian Home Medicines Review program: benefits and barriers

This study investigates Australian patients’ perceived benefits and barriers regarding HMRs from 14 focus groups.

It concluded that promotion of HMRs would increase patient uptake, and communicating the process/benefits clearly and sensitively would obviate consumer misconceptions and/or barriers.

Reference

Summary

Manger. 2019

Lifestyle interventions for mental health

This article, published in the Australian Journal of General Practice (AJGP), provides a concise update regarding the evidence-based clinical lifestyle interventions in the management of both mental illnesses and the physical chronic diseases highly prevalent in people with mental illness.

Bell et al. 2012

Anticholinergic and sedative medicines – prescribing considerations for people with dementia

This article, published in the Australian Family Physician, examines the clinical considerations associated with using anticholinergic and sedative medicines in people with dementia or incipient cognitive impairment.