The Japanese Society of Geriatric Pharmacy established the “Japanese Anticholinergic Risk Scale (JARS) Working Group,” comprising 15 members including physicians, dentists, pharmacists, and primary pharmaceutical researchers. The JARS supports healthcare professionals to evaluate anticholinergic risk accurately.

A systematic literature review identified 16 relevant articles. The review focused on medications available in Japan and excluded the topical and inhaled medications with localized effects or variable systemic absorption. Scores of JARS were determined by algorithms and expert consensus using the Delphi method. JARS assigns scores to 158 medications used in Japan, categorizing them into three potency groups: 37 drugs scored as 3 (strong), 27 as 2 (moderate), and 94 as 1 (weak).

JARS is a critical tool for assessing the anticholinergic burden in older Japanese populations. Although primary target of JARS is old adults, young individuals with underlying conditions may also be at increased risk of adverse drug reactions. Therefore, age-specific distinction was not made for JARS which is designed for pharmacists, physicians, dentists, nurses, and other healthcare professionals. The total anticholinergic burden on patients is calculated by summing each scores of individual medications, reflecting the risk posed by the cumulative anticholinergic effects.