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Safe prescribing in cognitively vulnerable patients: the use of the Anticholinergic Effect on Cognition (AEC) tool in Older Adult Mental Health Services

Research output: Contribution to journalArticlepeer-review

Delia Bishara, Charlotte Scott, Robert Stewart, David Taylor, Daniel Harwood, David Codling, Christine Banwell, Justin Sauer

Original languageEnglish
Pages (from-to)26-30
Number of pages5
JournalBJPsych Bulletin
Early online date8 Jul 2019
Accepted/In press3 Jun 2019
E-pub ahead of print8 Jul 2019


  • Safe prescribing paper

    Safe_prescribing_paper.pdf, 199 KB, application/pdf

    Uploaded date:07 Jun 2019

    Version:Accepted author manuscript

King's Authors


Aims and Methods
Medication with anticholinergic action is associated with potentially serious adverse effects in older people. We present an evaluation of a novel anticholinergic burden scale introduced into routine practice in older adult services in South London and Maudsley (SLaM) NHS Foundation Trust. Our aim was to assess whether this tool improved the accurate identification of anticholinergic medication and guided safer prescribing in cognitively vulnerable older people.
The introduction of the AEC tool into clinical practice led to an increase in the identification and reporting to GPs of anticholinergic medication from 11% to 85% of cases (p=0.0015).
Clinical implications
Application of the AEC tool led to improved detection of anticholinergic medication and advice to primary care on when a medication review is necessary. This is an important step towards improving the safety of prescribing in this patient group.

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