Artificial intelligence could help clinicians assess which patients are likely to encounter the harmful side effects of some commonly used antidepressants, antihistamines and bladder medicines.
From: University of Exeter
September 7, 2020 -- Research
led by the University of Exeter and Kent and Medway NHS and Social Care
Partnership Trust, published in Age and Ageing, assessed a new tool
designed to calculate which medicines are more likely to experience adverse
anticholinergic effects on the body and brain. These complications can occur
from many -prescription and over-the-counter drugs which affect the brain by
blocking a key neurotransmitter called acetylcholine. Many medicines, including
some bladder medications, anti-depressants, medications for stomach and
Parkinson's disease have some degree of anticholinergic effect. They are
commonly taken by older people.
Anticholinergic side
effects include confusion, blurred vision, dizziness, falls and a decline in
brain function. Anticholinergic effects may also increase risks of falls and
may be associated with an increase in mortality. They have also been linked to
a higher risk of dementia when used long term.
Now, researchers have
developed a tool to calculate harmful effects of medicines using artificial
intelligence. The team created a new online tool, International Anticholinergic
Cognitive Burden Tool (IACT), is uses natural language processing which is an artificial
intelligence methodology and chemical structure analysis to identify
medications that have anticholinergic effect.
The tool is the first
to incorporate a machine learning technique, to develop an automatically
updated tool available on a website portal. The anticholinergic burden is
assessed by assigning a score based on reported adverse events and aligning
closely with the chemical structure of the drug being considered for
prescription, resulting in a more accurate and up-to-date scoring system than
any previous system. Ultimately, after further research and modelling with real
world patient data the tool developed could help to support prescribing
reducing risks form common medicines.
Professor Chris Fox, at
the University of Exeter, is one of the study authors. He said:: "Use of
medicines with anticholinergic effects can have significant harmful effects for
example falls and confusion which are avoidable, we urgently need to reduce the
harmful side effects as this can leads to hospitalisation and death. This new
tool provides a promising avenue towards a more tailored personalised medicine
approach, of ensuring the right person gets a safe and effective treatment
whilst avoiding unwanted anticholinergic effects."
The team surveyed 110
health professionals, including pharmacists and prescribing nurses. Of this
group, 85 per cent said they would use a tool to assess risk of anticholinergic
side effects, if available. The team also gathered usability feedback to help
improve the tool further.
Dr Saber Sami, at the
University of East Anglia, said: "Our tool is the first to use innovative
artificial intelligence technology in measures of anticholinergic burden --
ultimately, once further research has been conducted the tool should support
pharmacists and prescribing health professionals in finding the best treatment
for patients."
Professor Ian Maidment,
from Aston University, said: "I have been working in this area for over 20
years. Anti-cholinergic side-effects can be very debilitating for patients. We
need better ways to assess these side-effects."
The research team
includes collaboration with AKFA University Medical School, Uzbekistan, and the
Universities of East Anglia, Aston, Kent and Aberdeen. They aim to continue
development of the tool with the aim that it can be deployed in day-to-day
practice which this study supports.
https://www.sciencedaily.com/releases/2022/09/220907093349.htm
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