{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T13:31:11Z","timestamp":1785763871781,"version":"3.56.0"},"reference-count":36,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2020,5,10]],"date-time":"2020-05-10T00:00:00Z","timestamp":1589068800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,9,26]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>This study evaluated the prevalence of prescribing drugs with constipation-inducing potential and the prophylactic use of laxatives in community-dwelling older adults.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Method<\/jats:title>\n                  <jats:p>An audit of outpatient prescriptions ordered for older adults aged \u226565 years with one or more chronic morbidities in 24 governmental primary healthcare centres in Bahrain. The prescriptions were collected by pharmacist-in-charge of each health centre between December 2015 and June 2016. The proportion of prescriptions with constipation-inducing drugs and co-prescribed laxatives was determined.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Key findings<\/jats:title>\n                  <jats:p>The overall prevalence of prescribing drugs with the potential to cause constipation was 30.5% (642\/2106). Prescriptions with at least one anticholinergic\/drug with anticholinergic potential (DAP) were 22.5% (473\/2106): single medication in 16.6% (350\/2106) and two or more combinations in 5.9% (124\/2106). A combination of two or more anticholinergics\/DAP accounted for 2.9% (61\/2106) prescriptions. Constipation-inducing drugs other than anticholinergics such as multivalent cation preparations and non-dihydropyridine calcium channel blockers were prescribed in 8.0% (168\/2106) of cases. Orphenadrine and first-generation antihistamines, both with high anticholinergic drug burden, were the frequently prescribed medications, either alone or combined. The rate of prescribed laxatives was 2.96% (19\/642), mostly for those on constipation-inducing drug monotherapy.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Approximately a third of prescriptions for older adults had constipation-inducing medications, typically a single DAP. Prescribing laxatives were uncommon and did not correlate with the prevalence of prescribing drugs with constipation potential. Physicians' awareness about anticholinergic drugs and their potential risks, and the prophylactic use of laxatives to mitigate iatrogenic constipation are to be included in continuing professional programmes.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1111\/ijpp.12636","type":"journal-article","created":{"date-parts":[[2020,5,11]],"date-time":"2020-05-11T05:11:59Z","timestamp":1589173919000},"page":"466-472","source":"Crossref","is-referenced-by-count":4,"title":["Prevalence of drugs with constipation-inducing potential and laxatives in community-dwelling older adults in Bahrain: therapeutic implications"],"prefix":"10.1093","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6591-7686","authenticated-orcid":false,"given":"Khalid A J","family":"Al Khaja","sequence":"first","affiliation":[{"name":"Department of Pharmacology & Therapeutics, College of Medicine & Medical Sciences, Arabian Gulf University, Manama, Kingdom of Bahrain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henry","family":"James","sequence":"additional","affiliation":[{"name":"Department of Pharmacology & Therapeutics, College of Medicine & Medical Sciences, Arabian Gulf University, Manama, Kingdom of Bahrain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sindhan","family":"Veeramuthu","sequence":"additional","affiliation":[{"name":"Department of Pharmacology & Therapeutics, College of Medicine & Medical Sciences, Arabian Gulf University, Manama, Kingdom of Bahrain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasin I","family":"Tayem","sequence":"additional","affiliation":[{"name":"Department of Pharmacology & Therapeutics, College of Medicine & Medical Sciences, Arabian Gulf University, Manama, Kingdom of Bahrain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kannan","family":"Sridharan","sequence":"additional","affiliation":[{"name":"Department of Pharmacology & Therapeutics, College of Medicine & Medical Sciences, Arabian Gulf University, Manama, Kingdom of Bahrain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reginald P","family":"Sequeira","sequence":"additional","affiliation":[{"name":"Department of Pharmacology & Therapeutics, College of Medicine & Medical Sciences, Arabian Gulf University, Manama, Kingdom of Bahrain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2020,5,10]]},"reference":[{"key":"2021031318401585800_ijpp12636-bib-0001","doi-asserted-by":"crossref","first-page":"1521","DOI":"10.1111\/j.1365-2036.2007.03540.x","article-title":"Cumulative incidence of chronic constipation: a population-based study 1988\u20132003","volume":"26","author":"Choung","year":"2007","journal-title":"Aliment Pharmacol Ther"},{"key":"2021031318401585800_ijpp12636-bib-0002","doi-asserted-by":"crossref","first-page":"525","DOI":"10.1097\/00004836-198910000-00008","article-title":"Clinical epidemiology of chronic constipation","volume":"11","author":"Johanson","year":"1989","journal-title":"J Clin Gastroenterol"},{"key":"2021031318401585800_ijpp12636-bib-0003","doi-asserted-by":"crossref","first-page":"663","DOI":"10.1503\/cmaj.120819","article-title":"Treatment of constipation in older people","volume":"185","author":"Gandell","year":"2013","journal-title":"Can Med Assoc J"},{"key":"2021031318401585800_ijpp12636-bib-0004","doi-asserted-by":"crossref","first-page":"401","DOI":"10.1001\/jamainternmed.2014.7663","article-title":"Cumulative use of strong anticholinergics and incident dementia: a prospective cohort study","volume":"175","author":"Gray","year":"2015","journal-title":"JAMA Intern Med"},{"key":"2021031318401585800_ijpp12636-bib-0005","first-page":"11","article-title":"Anticholinergic effects of medication in elderly patients","volume":"62","author":"Tune","year":"2001","journal-title":"J Clin Psychiatry"},{"key":"2021031318401585800_ijpp12636-bib-0006","doi-asserted-by":"crossref","first-page":"226","DOI":"10.3390\/ijerph15020226","article-title":"Association between drug usage and constipation in the elderly population of greater western Sydney Australia","volume":"15","author":"Fragakis","year":"2018","journal-title":"Int J Environ Res Public Health"},{"key":"2021031318401585800_ijpp12636-bib-0007","doi-asserted-by":"crossref","first-page":"2227","DOI":"10.1111\/jgs.13702","article-title":"American Geriatrics Society 2015 updated Beers criteria for potentially inappropriate medication use in older adults","volume":"2015","author":"American Geriatrics Society 2015 Beers Criteria Update Expert Panel","year":"2015","journal-title":"J Am Geriatr Soc"},{"key":"2021031318401585800_ijpp12636-bib-0008","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1093\/ageing\/afu145","article-title":"STOPP\/START criteria for potentially inappropriate prescribing in older people: version 2","volume":"44","author":"O'Mahony","year":"2015","journal-title":"Age Ageing"},{"key":"2021031318401585800_ijpp12636-bib-0009","doi-asserted-by":"crossref","first-page":"198","DOI":"10.1136\/pgmj.2007.062547","article-title":"Prescription writing skills of residents in a family practice residency programme in Bahrain","volume":"84","author":"Al Khaja","year":"2008","journal-title":"Postgrad Med J"},{"key":"2021031318401585800_ijpp12636-bib-0010","doi-asserted-by":"crossref","first-page":"523","DOI":"10.1007\/s40266-018-0549-z","article-title":"Anticholinergic drug burden tools\/scales and adverse outcomes in different clinical settings: a systematic review of reviews","volume":"35","author":"Welsh","year":"2018","journal-title":"Drugs Aging"},{"key":"2021031318401585800_ijpp12636-bib-0011","doi-asserted-by":"crossref","first-page":"198","DOI":"10.1001\/archpsyc.60.2.198","article-title":"Serum anticholinergic activity in a community-based sample of older adults: relationship with cognitive performance","volume":"60","author":"Mulsant","year":"2003","journal-title":"Arch Gen Psychiatry"},{"key":"2021031318401585800_ijpp12636-bib-0012","doi-asserted-by":"crossref","first-page":"753","DOI":"10.1002\/pds.3624","article-title":"Associations of drug burden index with falls, general practitioner visits, and mortality in older people","volume":"23","author":"Nishtala","year":"2014","journal-title":"Pharmacoepidemiol Drug Saf"},{"key":"2021031318401585800_ijpp12636-bib-0013","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1016\/j.amjopharm.2006.03.008","article-title":"Anticholinergic medications in community-dwelling older veterans: prevalence of anticholinergic symptoms, symptom burden, and adverse drug events","volume":"4","author":"Ness","year":"2006","journal-title":"Am J Geriatr Pharmacother"},{"key":"2021031318401585800_ijpp12636-bib-0014","first-page":"603","article-title":"Potentially inappropriate anticholinergic medication use in older adults with dementia","volume":"2015","author":"Kachru","year":"2003","journal-title":"J Am Pharm Assoc"},{"key":"2021031318401585800_ijpp12636-bib-0015","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1111\/j.1365-2125.2004.02232.x","article-title":"Drugs with anticholinergic properties and cognitive performance in the elderly: results from the PAQUID Study","volume":"59","author":"Lechevallier-Michel","year":"2005","journal-title":"Br J Clin Pharmacol"},{"key":"2021031318401585800_ijpp12636-bib-0016","doi-asserted-by":"crossref","first-page":"455","DOI":"10.1136\/bmj.38740.439664.DE","article-title":"Non-degenerative mild cognitive impairment in elderly people and use of anticholinergic drugs: longitudinal cohort study","volume":"332","author":"Ancelin","year":"2006","journal-title":"BMJ"},{"key":"2021031318401585800_ijpp12636-bib-0017","doi-asserted-by":"crossref","first-page":"311","DOI":"10.2217\/1745509X.4.3.311","article-title":"Impact of anticholinergics on the aging brain: a review and practical application","volume":"4","author":"Boustani","year":"2008","journal-title":"Ageing Health"},{"key":"2021031318401585800_ijpp12636-bib-0018","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1186\/s12877-015-0029-9","article-title":"Anticholinergic burden quantified by anticholinergic risk scales and adverse outcomes in older people: a systematic review","volume":"15","author":"Salahudeen","year":"2015","journal-title":"BMC Geriatrics"},{"key":"2021031318401585800_ijpp12636-bib-0019","doi-asserted-by":"crossref","first-page":"k1315","DOI":"10.1136\/bmj.k1315","article-title":"Anticholinergic drugs and risk of dementia: case-control study","volume":"361","author":"Richardson","year":"2018","journal-title":"BMJ"},{"key":"2021031318401585800_ijpp12636-bib-0020","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1007\/s40266-014-0230-0","article-title":"Impact of multiple low-level anticholinergic medications on anticholinergic load of community-dwelling elderly with and without dementia","volume":"32","author":"Mate","year":"2015","journal-title":"Drugs Aging"},{"key":"2021031318401585800_ijpp12636-bib-0021","doi-asserted-by":"crossref","first-page":"1249","DOI":"10.1007\/s00192-016-3258-3","article-title":"Anticholinergic prescription: are healthcare professionals the real burden?","volume":"28","author":"Araklitis","year":"2017","journal-title":"Int Urogynecol J"},{"key":"2021031318401585800_ijpp12636-bib-0022","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1111\/bcpt.12140","article-title":"Anticholinergic drug burden in older people's brain - how well is it measured?","volume":"114","author":"Kersten","year":"2014","journal-title":"Basic Clin Pharmacol Toxicol"},{"key":"2021031318401585800_ijpp12636-bib-0023","doi-asserted-by":"crossref","first-page":"589","DOI":"10.1177\/019262339402200603","article-title":"Constipation and megacolon in rats related to treatment with oxodipine, a calcium antagonist","volume":"22","author":"Nyska","year":"1994","journal-title":"Toxicol Pathol"},{"key":"2021031318401585800_ijpp12636-bib-0024","doi-asserted-by":"crossref","DOI":"10.1097\/MD.0000000000010631","article-title":"Chronic constipation: a review of literature","volume":"97","author":"Forootan","year":"2018","journal-title":"Medicine (Baltimore)"},{"key":"2021031318401585800_ijpp12636-bib-0025","first-page":"191","article-title":"Evaluating and managing constipation in the elderly","volume":"27","author":"Ginsberg","year":"2007","journal-title":"Urol Nurs"},{"key":"2021031318401585800_ijpp12636-bib-0026","doi-asserted-by":"crossref","first-page":"1","DOI":"10.5402\/2011\/757141","article-title":"The effect of amlodipine alone and in combination with atenolol on bowel habit in patients with hypertension: an observation","volume":"2011","author":"Saha","year":"2011","journal-title":"ISRN Gastroenterol"},{"key":"2021031318401585800_ijpp12636-bib-0027","doi-asserted-by":"crossref","first-page":"467","DOI":"10.1093\/qjmed\/hcr052","article-title":"Acute severe intestinal obstruction secondary to amlodipine toxicity","volume":"105","author":"Devasahayam","year":"2012","journal-title":"Q J Med"},{"key":"2021031318401585800_ijpp12636-bib-0028","doi-asserted-by":"crossref","first-page":"35","DOI":"10.4065\/83.1.35","article-title":"Improved attainment of blood pressure and cholesterol goals using single-pill amlodipine\/atorvastatin in African Americans: the CAPABLE trial","volume":"83","author":"Flack","year":"2008","journal-title":"Mayo Clin Proc"},{"key":"2021031318401585800_ijpp12636-bib-0029","doi-asserted-by":"crossref","first-page":"444","DOI":"10.12968\/bjcn.2015.20.9.444","article-title":"Approaches to managing chronic constipation in older people within the community setting","volume":"20","author":"Bardsley","year":"2015","journal-title":"Br J Community Nurs"},{"key":"2021031318401585800_ijpp12636-bib-0030","first-page":"917","article-title":"A multinational survey of prevalence and patterns of laxative use among adults with self-defined constipation","volume":"28","author":"Wald","year":"2008","journal-title":"Aliment Pharmacol Ther"},{"key":"2021031318401585800_ijpp12636-bib-0031","doi-asserted-by":"crossref","first-page":"147","DOI":"10.2165\/00002512-200724020-00006","article-title":"Use of laxatives among older nursing home residents in Helsinki, Finland","volume":"24","author":"Hosia-Randell","year":"2007","journal-title":"Drugs Aging"},{"key":"2021031318401585800_ijpp12636-bib-0032","doi-asserted-by":"crossref","first-page":"1215746","DOI":"10.1155\/2016\/1215746","article-title":"Constipation and laxative use among nursing home patients: prevalence and associations derived from the residents assessment instrument for long-term care facilities (interRAI LTCF)","volume":"2016","author":"Blekken","year":"2016","journal-title":"Gastroenterol Res Pract"},{"key":"2021031318401585800_ijpp12636-bib-0033","doi-asserted-by":"crossref","DOI":"10.17795\/nmsjournal13962","article-title":"Prevalence and effectiveness of laxative use among elderly residents in a regional hospital affiliated nursing home in Hsinchu County","volume":"3","author":"Chen","year":"2014","journal-title":"Nurs Midwifery Stud"},{"key":"2021031318401585800_ijpp12636-bib-0034","doi-asserted-by":"crossref","first-page":"457","DOI":"10.1177\/014107680009300903","article-title":"Anticholinergic side-effects of drugs in elderly people","volume":"93","author":"Mintzer","year":"2000","journal-title":"J R Soc Med"},{"key":"2021031318401585800_ijpp12636-bib-0035","doi-asserted-by":"crossref","first-page":"633","DOI":"10.1001\/archinte.1993.00410050067009","article-title":"Anticholinergic drug use and bowel function in nursing home patients","volume":"153","author":"Monane","year":"1993","journal-title":"Arch Intern Med"},{"key":"2021031318401585800_ijpp12636-bib-0036","doi-asserted-by":"crossref","first-page":"123","DOI":"10.5056\/jnm18035","article-title":"Functional chronic constipation: Rome III criteria versus Rome IV criteria","volume":"25","author":"Russo","year":"2019","journal-title":"J Neurogastroenterol Motil"}],"container-title":["International Journal of Pharmacy Practice"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fijpp.12636","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ijpp.12636","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/ijpp.12636","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/academic.oup.com\/ijpp\/article-pdf\/28\/5\/466\/36595715\/ijpp12636.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/ijpp\/article-pdf\/28\/5\/466\/36595715\/ijpp12636.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,3,13]],"date-time":"2021-03-13T18:41:29Z","timestamp":1615660889000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ijpp\/article\/28\/5\/466\/6133292"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,5,10]]},"references-count":36,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2020,5,10]]},"published-print":{"date-parts":[[2020,9,26]]}},"URL":"https:\/\/doi.org\/10.1111\/ijpp.12636","relation":{},"ISSN":["0961-7671","2042-7174"],"issn-type":[{"value":"0961-7671","type":"print"},{"value":"2042-7174","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2020,10]]},"published":{"date-parts":[[2020,5,10]]}}}