Association between prescribing of antimuscarinic drugs and antimuscarinic adverse effects in older people

Many commonly prescribed medications have antimuscarinic side effects. These can be severe and disabling, but it is not always possible to predict which patients will suffer these effects. The development of practical tools that predict the likelihood of adverse drug reactions would aid rational prescribing, thereby improving patient safety and outcomes. Avoiding predictable adverse drug reactions would also make significant cost savings. This paper discusses the current knowledge on the association between the prescribing of antimuscarinic drugs and adverse outcomes, and proposes novel ways to improve trial design, and data collection and interpretation in order to better identify those patients at the highest risk of antimuscarinic side effects.