Case Report: The Complexities of Managing Medications and the Importance of Deprescribing Anticholinergics in Older Adults
Open accessAbstract
Potentially inappropriate anticholinergic medications (including over-the-counter products), polypharmacy, and the existence of communication barriers among members of the interprofessional team frequently contribute to clinical complexity in older adults. We present the case of a frail 86-year old female from the perspective of a community pharmacist managing outpatient medications and transitions of care. CD’s past medical history is significant for dementia, multiple falls, recurrent urinary tract infections, depression, cardiac arrhythmia, macular degeneration, chronic pain, depression, and cerebrovascular disease.
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Carers' knowledge (e.g., health literacy, the patient's care needs) was linked to their experience of carer burden, and use of urgent care after returning home, and contributed to the ways they engaged with information provided at discharge.
“Carers’ knowledge (e.g., health literacy, the patient’s care needs) was linked to their experience of carer burden, and use of urgent care after returning home, and contributed to the ways they engaged with information provided at discharge [43, 44, 57, 59, 60, 64, 66, 67].”
From Do hospital-to-home transitions work for older adults with multiple long-term conditions including dementia? A realist review (2025) · cites this paper as [66]
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Experimental — accuracy not yet measuredUse of different electronic health record systems between providers presented an additional communication barrier, further limiting the transfer of diagnosis information.
“Use of different electronic health record systems between providers presented an additional communication barrier, further limiting the transfer of diagnosis information [45, 50, 53, 66].”
From Do hospital-to-home transitions work for older adults with multiple long-term conditions including dementia? A realist review (2025) · cites this paper as [66]
The Discussion (page not available) says that EHR systems did not interface, making timely communication of necessary information among the patient’s providers nearly impossible. The Limitations section adds that the pharmacist could not access care notes and lab results, but the paper does not specifically identify transfer of diagnosis information as the problem. (LLM, conf=0.82)
Experimental — accuracy not yet measuredHealthcare professionals working outside of geriatric care were often unaware of dementia diagnoses.
“As a result, HCPs working outside of geriatric care were often unaware of dementia diagnoses (CMOC14) [50, 53, 59, 66, 79, 86, 89].”
From Do hospital-to-home transitions work for older adults with multiple long-term conditions including dementia? A realist review (2025) · cites this paper as [66]
The Introduction identifies one patient as having diagnosed dementia. The Discussion describes communication difficulties among her healthcare providers, but does not say that providers outside geriatric care were unaware of her diagnosis or that this often occurred. Searches for provider awareness of dementia diagnoses found no passage addressing that point. (LLM, conf=0.73)
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Cites
By the 2019 American Geriatrics Society Beers Criteria® Update Expert Panel (2019) · Journal of the American Geriatrics Society · doi:10.1111/jgs.15767 · Cited by 3,163 · see citing works
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Clinical consequences of polypharmacy in elderly
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The anticholinergic risk scale and anticholinergic adverse effects in older persons
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Therapeutic dilemmas: cognitive enhancers and risk of falling in older adults—a clinical review
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Falfaly, Z., Peterson, G. M., Bezabhe, W. M. M., & Salahudeen, M. S. (2026) · Medical Sciences · doi:10.3390/medsci14040426
- Authors
- Elliott, T., Eckmann, L., & Moga, D. C.
- Affiliations
- University of Kentucky (US)
- Corresponding author
- Moga, Daniela C.
- Venue
- Frontiers in Pharmacology
- Publisher
- Frontiers Media SA
- Published
- 2021-04-16
- Volume
- 12
- Pages
- 584667-584667
- ISSN
- 1663-9812 (ISSN-L)
- PMC
- PMC8087073
- OpenAlex
- W3152691811
- Cited by
- 6
- References
- 8
- Citations by year
- 2026: 1 · 2025: 2 · 2023: 2 · 2021: 1
- FWCI
- 0.42
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Frontiers in Pharmacology (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- UKnowledge (University of Kentucky) (submittedVersion, cc-by)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- National Institute on Aging (R01 AG054130)
- Topics
- Health Sciences › Medicine › Geriatrics and Gerontology › Pharmaceutical Practices and Patient Outcomes
- Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Pharmacology › Pharmacy and Medical Practices
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Opioid Use
- Keywords
- potentially inappropriate medications, polypharmacy, older adults, frailty, community pharmacy, care transitions, interprofessional communication, dementia, falls, urinary tract infection, medication management
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