The project was implemented on an eleven bedded older adult functional mental health ward which caters for ladies over the age of 65 with a functional mental health condition.
Our aim was to score every patient’s anticholinergic burden (ACB) score on admission and document within their electronic records within the multidisciplinary team (MDT) document within a week of admission. Another aim was to conduct medication reviews where a patient’s score was 3 or above within a month of admission. A score of 3 or above is associated with increased adverse events. The score was included in the MDT discussion and inn turn, we hoped this would reduce the score wherever was possible.
Awareness of anticholinergic burden was increased on the ward through staff learning and discussions within meetings.Out of 24 patients 23/24 had their ACB score calculated and documented within their notes within a week of admission.
Out of 8 patients whose ACB was 3 or above on admission 4 had a dedicated pharmacist ACB medication review within a month of admission. However all patients had a medication review within MDT meetings as part of the new ACB template within the MDT document. It is worth noting that the 4 pharmacist ACB medication reviews that were not able to be completed, 3 of the patients had a reduction in their ACB score overall.Out of 24 patients admitted during the test of change 50% had a reduction in their ACB score (12/24) through discussion and dedicated ACB medication reviews. 42% of the scores that were reduced (5/12) were reduced to below 3 which is now out of the higher risk area associated with adverse events.
