Potentially inappropriate prescriptions of anticholinergic drugs in patients with benign prostatic hyperplasia

Background: Prostatic hyperplasia is frequent in the elderly, and it can be associated with
urinary retention in patients who use cholinergic antagonists. The objective was to estimate the
anticholinergic burden of drugs prescribed to patients diagnosed with benign prostatic
hyperplasia.
Methods: A cross-sectional study using a population database to identify prescriptions of
cholinergic antagonists drugs used in the management of benign prostatic hyperplasia. The
anticholinergic burden was evaluated using the Anticholinergic Drug Scale.
Results: Three thousand seven hundred and sixty patients with benign prostatic hyperplasia
were identified, with a mean age of 68.26 ± 10.46 years. Of these patients, 2961 (78.8%) received
pharmacological treatment mainly with tamsulosin monotherapy (34.7%, n 1⁄4 1026). Overall,
34.7% (n 1⁄4 1303) of all patients were taking cholinergic antagonists. Patients aged 75–84 years
(OR: 1.985, 95%CI: 1.063–3.709) and those 85 or older (OR: 2.52, 95%CI: 1.287–4.948) had a
greater probability of having an anticholinergic burden score 3 points. Of the patients not
receiving pharmacological treatment for benign prostatic hyperplasia, 35% (n 1⁄4 280) were taking
medications with anticholinergic properties.
Conclusions: A high proportion of patients with benign prostatic hyperplasia were receiving
medical management for the relief of symptoms, mostly via monotherapy. However, one-third
of patients received some type of medication with anticholinergic properties, being much more
frequent after 75 years.