Anticholinergic Burden and its Determinants among Adult in-patients at University of Gondar Comprehensive Specialized Hospital, North-west Ethiopia, 2022.

Abstract

Abstract Background: Numerous studies report that anticholinergic burden has linked with several health consequences, including an increased hospital admission, prolonged hospitalization and physical and cognitive impairment. Objective: To assess anticholinergic burden and its determinants among adult in-patients at university of Gondar comprehensive specialized hospital, Gondar, North-west Ethiopia, 2022. Methods: A cross-sectional study was conducted from June to August 2022 at University of Gondar Comprehensive Specialized Hospital on adult inpatients. A pre-tested questionnaire was utilized to collect data from patients and their corresponding medical chart. Convenient sampling technique were used to select the participants. SPSS version 25 was used to analyze the data. Descriptive statistics including means, frequencies and standard deviations were used to describe some variables of interest. Logistic regression analysis was done to check for possible associations between variables. Level of significance was set at p< 0.05 at 95% CI. Result: A total of 420 patients participated in this study. 58.3% of them were exposed to medicines with anticholinergic property. Clinically significant anticholinergic burden was observed in 47(11.2%) of participants. Charlson comorbidity index score of 1 or 2(AOR = 4.7; 95% CI: 1.404– 15.9), polypharmacy (AOR = 2.8(95% CI: 1.065, 7.5), excessive polypharmacy (AOR = 15.8 (95% CI: 2.15, 116.7), being admitted to a psychiatric ward (AOR = 90.3(95% CI: 13.9, 590.5), and co-morbid with diabetes mellitus (AOR = 3.3(95% CI: 1.003, 10.75) were significantly associated with clinically significant anticholinergic burden. Conclusion: Clinically significant anticholinergic burden was observed in 11.2% of current study subjects. Participants with polypharmacy, admitted to psychiatric ward, Charlson comorbidity index score of 1 or 2, excessive polypharmacy and comorbid diabetes mellitus were more likely to experience clinically significant anticholinergic burden. Recommendations: The prescribers and clinical pharmacist need to be work in collaborative to review the patient’s medication regimen among the patients who are most exposed to anticholinergics. Keywords: Anticholinergic burden, hospitalization, adult, anticholinergic cognitive burden score