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. 2024 Dec;46(6):1352-1361.
doi: 10.1007/s11096-024-01769-z. Epub 2024 Jul 15.

Anticholinergic burden and health-related quality of life among adult patients in a resource-limited setting: a cross-sectional study

Eyob Alemayehu Gebreyohannes  1   2   3 , Biniam Siyum Shibe  4 , Wagaye Atalay Taye  4 , Kenneth Lee  5 , Ousman Abubeker Abdela  6   4 , Emneteab Mesfin Ayele  4 , Eyayaw Ashete Belachew  4 , Segenet Bizuneh Mengistu  7 , Phyo Kyaw Myint  6 , Roy Louis Soiza  6
Affiliations

Anticholinergic burden and health-related quality of life among adult patients in a resource-limited setting: a cross-sectional study

Eyob Alemayehu Gebreyohannes et al. Int J Clin Pharm. 2024 Dec.

Abstract

Background: Anticholinergic medications are now widely acknowledged for their unfavorable risk-to-benefit profile owing to their adverse effects. Health-related quality of life (HRQoL) is commonly regarded as a crucial person-centered outcome.

Aim: This study aimed to investigate the association between anticholinergic burden and HRQoL in hospitalized and ambulatory patients seen in Ethiopia.

Method: This cross-sectional study utilized a questionnaire and medical records to collect data from a convenience sample of adult patients attending both inpatient wards and ambulatory clinic of University of Gondar Comprehensive Specialized Hospital between April and September 2022. Anticholinergic burden was measured by anticholinergic cognitive burdens scale (ACBS), while HRQoL was measured using EQ5D-index (Euroqol-5 dimensions-5-Levels index) and EQ5D-VAS (visual analogue scale). Linear regression was used to assess the influence of high anticholinergic burden (ACBS score ≥ 3) on EQ5D-index and EQ5D-VAS, with adjustments made for sociodemographic and clinical confounders.

Results: A total of 828 patients participated in this study (median (IQR) age was 45.0 (30, 60) and 55.9% were female). On multiple linear regression analysis, high anticholinergic burden was associated with a statistically significant decline in HRQoL, as evidenced by reductions in both EQ5D index (- 0.174 (- 0.250, - 0.098)) and EQ5D-VAS scores (- 9.4 (- 13.3, - 5.2)).

Conclusion: A significant association between high anticholinergic burden and diminished HRQoL was found among a relatively younger cohort in a resource-limited setting, even after adjustment for important confounding variables. Clinicians should be cognizant of the cumulative impact of anticholinergic burden on HRQoL outcomes and strive to minimize anticholinergic burden.

Keywords: Anticholinergics; Drug-related side effects and adverse reactions; Health-related quality of life; Medication safety.

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Conflict of interest statement

Conflicts of interest There are no conflicts of interest declared by the authors.

Figures

Fig. 1
Fig. 1
Frequency of medications with anticholinergic activity by anticholinergic burden class. ACB Anticholinergic burden
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