The research by the University of Exeter, Kent and Midway NHS and the Social Care Partnership Trust, was published in age and aging, evaluated a new tool designed to calculate drugs most likely to experience anticholinergic effects on the body and brain. This complication can occur from many over-the-counter medications that affect the brain by blocking a key neurotransmitter called acetylcholine. Many medications, including some bladder medications, antidepressants, stomach medications, and Parkinson’s disease medications have some degree of anticholinergic effect. It is usually taken by the elderly.
Side effects of anticholinergics include confusion, blurred vision, dizziness, falls, and decreased brain function. Anticholinergic effects may also increase the risk of falls and may be associated with an increase in mortality. It has also been linked to an increased risk of dementia when used long-term.
Now, researchers have developed a tool to calculate the adverse effects of drugs using artificial intelligence. The team created a new online tool, the International Cognitive Burden of Anticholinergics (IACT) Tool, that uses natural language processing an AI methdolody and chemical structure analysis to identify drugs that have an anticholinergic effect.
The tool is the first to integrate machine learning technology, to develop an automatically updated tool available on the website portal. Anticholinergic burden is assessed by assigning a score based on reported adverse events and closely aligning with the chemical composition of the drug being considered for prescription, resulting in a more accurate and up-to-date scoring system than any previous regimen. Ultimately, after further research and modeling using real-world patient data, the tool developed could help support prescribing risk-reducing medications from common medications.
Professor Chris Fox from the University of Exeter is one of the study’s authors. He said, “The use of drugs with anticholinergic effects can have significant adverse effects such as avoidable falls and disorientation, and we urgently need to reduce adverse side effects as this can lead to hospitalization and death. This new tool provides a promising avenue toward an approach to More detailed personalized medical care, to ensure the right person receives safe and effective treatment while avoiding unwanted anticholinergic effects.”
The team surveyed 110 health professionals, including pharmacists and nurses. Of this group, 85 percent said they would use a tool to assess the risk of anticholinergic side effects, if one were available. The team also collected usability feedback to help improve the tool further.
Our tool is the first to use innovative AI technology in measures of anticholinergic burden — and eventually, once more research is done, the tool should support pharmacists and prescribe health professionals in finding the best treatment for patients.”
Dr. Saber Sami, University of East Anglia
Professor Ian Maidment, from Aston University, said: “I’ve been in the field for over 20 years. Anticholinergic side effects can be very debilitating for patients. We need better ways to assess these side effects.”
The research team includes collaborations with the AKFA University School of Medicine, Uzbekistan, and the universities of East Anglia, Aston, Kent and Aberdeen. It aims to further develop the tool with a view to its diffusion in daily practice supported by this study.
Secchi, A., et al. (2022) A new AI-based tool for assessing anticholinergic burden: a survey. Age and old age. doi.org/10.1093/ageing/afac196.