Anticholinergic Burden in Geriatric Patients Attending Clinical Pharmacology Clinic — A Descriptive Cross-sectional Study in Eastern India

ABSTRACT

Background: Anticholinergic burden in Geriatric population is of great concern throughout the Globe, yet often neglected. There are previous studies to assess the Anticholinergic burden, carried out in specific population, though its prevalence in general population is difficult to interpret. Polypharmacy remains one of the major causes contributing to the increased burden in Anticholinergic score among Geriatrics. Multiple co-morbidities and the prevalence of Multiple Chronic Diseases are the responsible factors which imbibe Multiple Drug Therapy in Geriatric population. Anticholinergic burden in older adults has been associated with Cognitive impairment, Delirium, Dizziness and Confusion, Falls and increased hospitalizations. However, Anticholinergic-acting drugs are often advised in Geriatric population. In this study an attempt was made to understand the Anticholinergic burden score among Geriatric population. Methods: This study is a descriptive cross-sectional study, which was done, in a period of six months among 62 Geriatric patients attending a therapeutics clinic of a private clinical pharmacology OPD for first time. Patients were noted for their comorbidities and anticholinergic burden was calculated, based on the Anticholinergic Cognitive Burden scale. Results were statistically analyzed. Results: Clinically significant anticholinergic burden was observed in 22.58% population. The most frequently prescribed drug was found to be alprazolam followed by amitriptyline and theophylline. Among the comorbidities hypertension and diabetes was commonly seen in majority of the population. Conclusion: Co-professional care at clinical pharmacology OPD with assessment of anticholinergic burden of geriatric prescriptions and advices on rational de-prescribing with suggestions on safer alternatives would be beneficial for treating physicians to optimize therapy.