Investigating the Impact of Polypharmacy and Anticholinergic Medication Burden on Objective Cognitive Performance in Adults With Multiple Sclerosis

Author:

Huebner Joanie1ORCID,Robichaud Jade2,Cozart Julia S.23,Burkhardt Crystal4,Lynch Sharon G.5,Bruce Jared M.26

Affiliation:

1. From the Department of Community and Family Medicine, University Health Lakewood Medical Center, University of Missouri–Kansas City, Kansas City, MO (JH)

2. Department of Biomedical and Health Informatics, School of Medicine, University of Missouri–Kansas City, Kansas City, MO (JR, JSC, JMB)

3. Department of Psychology, University of Missouri–Kansas City, Kansas City, MO (JSC)

4. Department of Pharmacy Practice, University of Kansas Medical Center, Kansas City, MO (CB)

5. Department of Neurology, University of Kansas Medical Center, Kansas City, KS (SGL)

6. Departments of Neurology and Psychiatry, University Health Truman Medical Center, Kansas City, MO (JMB).

Abstract

CE INFORMATION ACTIVITY AVAILABLE ONLINE: To access the article and evaluation online, go to https://www.highmarksce.com/mscare. TARGET AUDIENCE: The target audience for this activity is physicians, advanced practice clinicians, nursing professionals, pharmacists, researchers, and other health care providers involved in the study and management of patients with multiple sclerosis (MS). LEARNING OBJECTIVE: Review current research, including limitations, of the potential cognitive impacts of polypharmacy and anticholinergic burden in individuals with MS. Evaluate potential cognitive risks associated with polypharmacy and anticholinergic burden using tools such as the Drug Burden Index to guide decision-making in the development of comprehensive treatment plans. ACCREDITATION: In support of improving patient care, this activity has been planned and implemented by the Consortium of Multiple Sclerosis Centers (CMSC) and Intellisphere, LLC. The CMSC is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the health care team. This activity was planned by and for the health care team, and learners will receive 1.0 Interprofessional Continuing Education (IPCE) credit for learning and change. PHYSICIANS: The CMSC designates this journal-based activity for a maximum of 1.0 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity. NURSES: The CMSC designates this enduring material for 1.0 contact hour of nursing continuing professional development (NCPD) (1.0 in the area of pharmacology). PHARMACISTS: This knowledge-based activity (UAN JA4008165-9999-24-004-H01-P) qualifies for 1.0 contact hour (.01 CEUs) of continuing pharmacy education credit. PAS: The CMSC has been authorized by the American Academy of PAs (AAPA) to award AAPA Category 1 CME credit for activities planned in accordance with AAPA CME Criteria. The activity is designated for 1.0 AAPA Category 1 CME credits. PAs should only claim credit commensurate with the extent of their participation. PSYCHOLOGISTS: This activity is awarded 1.0 CE credit. DISCLOSURES: It is the policy of the Consortium of Multiple Sclerosis Centers to mitigate all relevant financial disclosures from planners, faculty, and other persons that can affect the content of this CE activity. For this activity, all relevant disclosures have been mitigated. Francois Bethoux, MD, editor in chief of the International Journal of MS Care (IJMSC), has served as physician planner for this activity. He has disclosed no relevant financial relationships. Alissa Mary Willis, MD, associate editor of IJMSC, has disclosed not relevant financial relationships. Sharon G. Lynch, MD, has disclosed financial relationships with Atara Biotherapeutics, Biogen, Bristol Myers Squibb, Immunic, Novartis, Pipeline, Roche, Sanofi, TG Therapeutics, and UCB (researcher). Authors Joanie Huebner, PhD; Jade Robichaud, BA; Julia S. Cozart, MA; and Jared M. Bruce, PhD, have disclosed no relevant financial relationships. At the time of this research and authorship, author Crystal Burkhardt, PharmD, disclosed no relevant financial relationships. Subsequent to the selection of this paper for publication and continuing education credit, she began an employee relationship with Astra Zeneca. The staff at IJMSC, CMSC, and Intellisphere, LLC who are in a position to influence content have disclosed no relevant financial relationships. Laurie Scudder, DNP, NP, continuing education director CMSC, has served as a planner and reviewer for this activity. She has disclosed no relevant financial relationships. METHOD OF PARTICIPATION: Release Date: March 1, 2024; Valid for Credit through: March 1, 2025 To receive CE credit, participants must: (1) Review the continuing education information, including learning objectives and author disclosures.(2) Study the educational content.(3) Complete the evaluation, which is available at https://www.highmarksce.com/mscare. Statements of Credit are awarded upon successful completion of the evaluation. There is no fee to participate in this activity. DISCLOSURE OF UNLABELED USE: This educational activity may contain discussion of published and/or investigational uses of agents that are not approved by the FDA. The CMSC and Intellisphere, LLC do not recommend the use of any agent outside of the labeled indications. The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of the CMSC or Intellisphere, LLC. DISCLAIMER: Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information presented in this activity is not meant to serve as a guideline for patient management. Any medications, diagnostic procedures, or treatments discussed in this publication should not be used by clinicians or other health care professionals without first evaluating their patients’ conditions, considering possible contraindications or risks, reviewing any applicable manufacturer’s product information, and comparing any therapeutic approach with the recommendations of other authorities.

Publisher

Consortium of Multiple Sclerosis Centers

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