Abstract:
Abstract
Background: Anticholinergic burden may lead to severe adverse effects which ultimately
influence health-related quality of individuals.
Objectives: To assess the anticholinergic burden and its association with health-related quality
of life, among adult outpatients in the University of Gondar comprehensive specialized hospital
ambulatory care clinic.
Methods: Institutional based cross-sectional study was conducted from May to July, 2022. A
pretested data collection tool was used to extract information from patients and medical charts
and EQ-5D was employed to measure health related quality of life. Descriptive statistics was
used to present the prevalence and categorical data. Binary Logistic regression analysis was
done to determine predictors of anticholinergic burden and its association with HRQoL. A pvalue
of
<0.05
was
considered
statistically
significant
with
confidence
interval
of 95%.
Results:
A
total
of
409
patients
participated
in
the
study.
One
third
(32%)
of
the
subjects
took
at
least
one medicine with anticholinergic properties. Among them only 10.1% of the study
subjects were exposed to clinically significant anticholinergic burden. Patients who had received
one [AOR = 0.147 (95% CI: (0.034, 0.645), P=0.011] and two medications [AOR = 0.306 (95%
CI: 0.109, 0.857), P=0.024] were significantly associated with low anticholinergic burden. The
HRQoL assessment yields nearly half of the participants (48.4%) had good quality of life. The
mean EQ-5D score was 9.98 ± 4.02. After controlling other factors clinically significant
anticholinergic burden was associated with poor HRQoL (AOR= 0.323, 95% CI (0.138, 0.756).
Being urban dwellers (AOR= 1.925, 95% CI: 1,175,3.156), being partly skilled worker (AOR
=11.686, 95% CI: (1.270, 107.510), being unmarried (AOR= 0.384, 95% CI: (0.169, 0.872),
being divorced (AOR= 0.240, 95%CI: (0.076, 0.753), managerial and technical occupation
(AOR= 0.188, 95% CI (0.038, 0.939) were some other factors associated with HRQoL (P<0.05).
Conclusion & recommendation: One-third of studied patients were exposed to at least one
anticholinergic drug. Clinically significant anticholinergic burden was associated with a poor
HRQoL. Clinical pharmacists in collaboration with other health professionals may need to
intervene to reduce the use of multiple medicines with clinical significant anticholinergic effects.
Keywords:Health related quality of life, Anticholinergic burden, determinants, associated
factors
