Delia Bishara
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View article: The use of NHS databases to identify and manage pharmacotherapy in people with dementia and/or late-life mental disorders
The use of NHS databases to identify and manage pharmacotherapy in people with dementia and/or late-life mental disorders Open
NHS databases have particular value because of comprehensive catchment-based care provided by mental health and dementia diagnostic services and detailed long-term prescribing data captured in primary care. However, care for these disorder…
View article: Medications associated with dizziness or hypotension and adverse outcomes: an electronic health record study in older adults with dementia
Medications associated with dizziness or hypotension and adverse outcomes: an electronic health record study in older adults with dementia Open
Background Comorbidities and polypharmacy are common in people with dementia, leading to a higher risk of adverse outcomes. While the impact of anticholinergic properties has been extensively investigated, less is known about other cross-c…
View article: Natural language processing application to identify covert administration of medicines: development and pilot audit
Natural language processing application to identify covert administration of medicines: development and pilot audit Open
Aims and method The covert administration of medicines is associated with multiple legal and ethical issues. We aimed to develop a natural language processing (NLP) methodology to identify instances of covert administration from electronic…
View article: Risk of dementia associated with anticholinergic drugs for overactive bladder in adults aged ≥55 years: nested case-control study
Risk of dementia associated with anticholinergic drugs for overactive bladder in adults aged ≥55 years: nested case-control study Open
Objective To investigate whether different anticholinergic drug treatments for overactive bladder have differential risks for incident dementia, in a large representative population of older adults in England. Design Nested case-control st…
View article: Understanding the medication regimens associated with anticholinergic burden in older people's mental health services in the UK
Understanding the medication regimens associated with anticholinergic burden in older people's mental health services in the UK Open
Background Medications with anticholinergic properties are associated with a range of adverse effects that tend to be worse in older people. Aims To investigate medication regimens with high anticholinergic burden, prescribed for older adu…
View article: Embedding a Quality Framework for medication safety standards in delirium and dementia: A Singapore Study in a geriatric psychiatry liaison service
Embedding a Quality Framework for medication safety standards in delirium and dementia: A Singapore Study in a geriatric psychiatry liaison service Open
Introduction Research on prescribing processes for psychotropic medication review in older adult patients with severe behavioural symptoms of delirium and dementia appears limited. We aimed to improve and achieve 100% clinical documentatio…
View article: Risk of dementia associated with bladder anticholinergic drugs: a case-control study of older adults in UK primary care
Risk of dementia associated with bladder anticholinergic drugs: a case-control study of older adults in UK primary care Open
CONTEXT: Evidence from previous studies suggest an association between anticholinergic drugs commonly used to treat overactive bladder (OAB) symptoms in older adults, and risk of dementia. It is uncertain whether differences exist between …
View article: A tool for safer prescribing in vulnerable adults: the continuing development of the Medichec app and website
A tool for safer prescribing in vulnerable adults: the continuing development of the Medichec app and website Open
Aims and method Adverse effects are a common concern when prescribing and reviewing medication, particularly in vulnerable adults such as older people and those with intellectual disability. This paper describes the development of an app g…
View article: Managing drugs with anticholinergic activity
Managing drugs with anticholinergic activity Open
Over the past two decades, considerable data have emerged on an association between drugs with anticholinergic activity and serious adverse effects in older people. Well-recognised anticholinergic adverse effects include dry mouth, blurred…
View article: Can medication mentions in CRIS be used for researching medication use in older people with dementia? Comparing the natural language processing app for medicines to GP prescribing
Can medication mentions in CRIS be used for researching medication use in older people with dementia? Comparing the natural language processing app for medicines to GP prescribing Open
Background The efficacy of long-term preventative medication in people who have dementia and other comorbidities is unknown. Electronic health record-based observational studies may play a role in evaluating medicines, and SLaM-CRIS is one…
View article: Anticholinergic action is rarely a good thing
Anticholinergic action is rarely a good thing Open
The evidence for the risks associated with anticholinergic agents has grown considerably in the last two decades. Not only are they associated with causing peripheral side effects such as dry mouth, blurred vision and constipation, but the…
View article: Improving quantification of anticholinergic burden using the Anticholinergic Effect on Cognition Scale – a healthcare improvement study in a geriatric ward setting
Improving quantification of anticholinergic burden using the Anticholinergic Effect on Cognition Scale – a healthcare improvement study in a geriatric ward setting Open
Objective Anticholinergic burden refers to the cumulative effects of taking multiple medications with anticholinergic effects. This study was carried out in a public hospital in Singapore, aimed to improve and achieve a 100% comprehensive …
View article: Centrally-acting anticholinergic drugs– associations with mortality, hospitalisation and cognitive decline following dementia diagnosis in people receiving antidepressant and antipsychotic drugs
Centrally-acting anticholinergic drugs– associations with mortality, hospitalisation and cognitive decline following dementia diagnosis in people receiving antidepressant and antipsychotic drugs Open
These counter-intuitive findings may reflect factors underlying the choice of psychotropics rather than the agents themselves, although do not support a strong role for central anticholinergic drug actions on dementia outcomes. Further stu…
View article: Antipsychotic monitoring in dementia: quality of completion of antipsychotic monitoring forms in an older adult mental health service
Antipsychotic monitoring in dementia: quality of completion of antipsychotic monitoring forms in an older adult mental health service Open
Aims and method To support safe prescribing of antipsychotics in dementia, antipsychotic monitoring forms were embedded into our electronic health records. We present a review of the data collected on these forms to assess prescribing and …
View article: Anticholinergic drugs and risk of dementia: Time for action?
Anticholinergic drugs and risk of dementia: Time for action? Open
Evidence suggests that the prescription of bladder anticholinergics is increasing. Recent studies have accentuated concerns about whether certain prescribed medications could increase risk of dementia, including anticholinergic drugs, and …
View article: Aspirin in people with dementia, long-term benefits, and harms: a systematic review
Aspirin in people with dementia, long-term benefits, and harms: a systematic review Open
View article: The anticholinergic effect on cognition (AEC) scale: Associations with mortality, hospitalisation and cognitive decline following dementia diagnosis
The anticholinergic effect on cognition (AEC) scale: Associations with mortality, hospitalisation and cognitive decline following dementia diagnosis Open
Objectives To investigate associations between central anticholinergic burden (using the AEC scale), and mortality, hospitalisation and cognitive decline in patients with dementia. Methods The South London and Maudsley NHS Foundation Trust…
View article: The anticholinergic effect on cognition (<scp>AEC</scp>) scale—Associations with mortality, hospitalisation and cognitive decline following dementia diagnosis
The anticholinergic effect on cognition (<span>AEC</span>) scale—Associations with mortality, hospitalisation and cognitive decline following dementia diagnosis Open
Objectives To investigate associations between central anticholinergic burden (determined through the anticholinergic effect on cognition [AEC] scale) and mortality, hospitalisation and cognitive decline in patients with dementia. Methods …
View article: ‘Real time’ monitoring of antipsychotic prescribing in patients with dementia: a study using the Clinical Record Interactive Search (CRIS) platform to enhance safer prescribing
‘Real time’ monitoring of antipsychotic prescribing in patients with dementia: a study using the Clinical Record Interactive Search (CRIS) platform to enhance safer prescribing Open
Background The use of antipsychotic drugs in dementia has been reported to be associated with increased risk of cerebrovascular events and mortality. There is an international drive to reduce the use of these agents in patients with dement…
View article: Benefits and Harms of Statins in People with Dementia: A Systematic Review and Meta‐Analysis
Benefits and Harms of Statins in People with Dementia: A Systematic Review and Meta‐Analysis Open
OBJECTIVES More people with dementia also fall into the category of high vascular risk, for which a statin is usually prescribed. However, these recommendations are based on studies in people without dementia. We aimed to evaluate the evid…
View article: Emerging and experimental treatments for COVID-19 and drug interactions with psychotropic agents
Emerging and experimental treatments for COVID-19 and drug interactions with psychotropic agents Open
As yet, no agents have been approved for the treatment of COVID-19, although several experimental drugs are being used off licence. These may have serious adverse effects and potential drug interactions with psychotropic agents. We reviewe…
View article: Safe prescribing in cognitively vulnerable patients: the use of the anticholinergic effect on cognition (AEC) tool in older adult mental health services
Safe prescribing in cognitively vulnerable patients: the use of the anticholinergic effect on cognition (AEC) tool in older adult mental health services Open
Aims and method 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…
View article: [P1–511]: IMPROVING ACCESSIBILITY TO THE EVIDENCE‐BASED ANTICHOLINERGIC EFFECT ON COGNITION (AEC) SCALE THROUGH DEVELOPMENT OF AN APP‐BASED RESOURCE
[P1–511]: IMPROVING ACCESSIBILITY TO THE EVIDENCE‐BASED ANTICHOLINERGIC EFFECT ON COGNITION (AEC) SCALE THROUGH DEVELOPMENT OF AN APP‐BASED RESOURCE Open
There is growing recognition that medicines with anticholinergic activity are associated with an increased risk of cognitive impairment, dementia and mortality. We developed an evidence-based tool to assist practitioners in determining the…
View article: Anticholinergic effect on cognition (AEC) of drugs commonly used in older people
Anticholinergic effect on cognition (AEC) of drugs commonly used in older people Open
Objective Use of anticholinergic drugs in older people is associated with increased risk of cognitive decline and of dementia and death. Method We identified drugs widely used in older people and attempted to classify their anticholinergic…
View article: The pharmacological management of Alzheimer's disease
The pharmacological management of Alzheimer's disease Open
cognitive enhancers in Alzheimer's disease (AD) and other dementias and provide an overview of new treatments in development.