Anticholinergic burden and its association with Health related quality of life among adult outpatients at University of Gondar Comprehensive Specialized Hospital

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