A new Electronic Patient Record (EPR) tool, the Anticholinergic Medication Index (ACMI), will go live across CHFT on Tuesday, 1st September.

The ACMI is a calculator and clinical decision support tool designed to help prescribers and pharmacists assess a patient's anticholinergic burden. Anticholinergic medicines can be associated with adverse outcomes such as delirium and falls, particularly in older patients. The ACMI uses a validated scoring system based on 88 commonly prescribed medicines, with higher scores indicating a greater risk of these outcomes.

Integrated directly into EPR, the tool automatically calculates and updates ACMI scores whenever an anticholinergic medication is prescribed, changed or discontinued. It will be available for patients aged 65 years and over in inpatient and day-case settings.

The ACMI will support colleagues in identifying patients with high anticholinergic burden and enable shared decision-making about medicine optimisation. Guidance thresholds classify scores as:

• Low: 0 to 1
• Intermediate: greater than 1 to 2
• High: 2 or above

Colleagues will be able to view ACMI information across several EPR areas, including clinician workflow, results review, assessments/fluid balance, related results and the pharmacy care organiser. Additional information, including a breakdown of contributing medications, can also be accessed within the system.

The ACMI forms part of an ongoing research project, and feedback will be sought from colleagues, particularly those working on elderly care wards, to support its future development.

Please contact eprescribe@this.nhs.uk for technical queries or for any other questions or feedback, please email Rosemary.Shannon@bthft.nhs.uk and A.S.M.Abuzour@leeds.ac.uk