Anticholinergic burden and its predictors among patients with schizophrenia in Northwest Ethiopia: An institutional-based cross sectional study

Abstract

Background: Many drugs prescribed for individuals with schizophrenia have anticholinergic effects. When these medications are used together, they can create a substantial overall Anticholinergic Burden (ACB). Objective: The aim of this study was to assess the prevalence of ACB and its predictors among patients with schizophrenia at selected comprehensive specialized hospitals in Northwest Ethiopia. Design: A multicenter cross sectional study was conducted. Methods: The study included 406 patients with schizophrenia at selected specialized hospitals in Northwest Ethiopia between June and August 2022. Study participants were recruited using systematic random sampling. The Anticholinergic Cognitive Burden Score (ACBS) was used to assess ACB. Data were entered using EpiData version 4.6.0 and analyzed with SPSS version 26. Multivariable logistic regression analysis was performed to determine the predictors of high ACB, with variables having a p-value < 0.05 at a 95% confidence interval considered statistically significant. Results: The prevalence of high ACB was 34.2%. Older patients [Adjusted Odds Ratio (AOR) = 3.26, 95% CI: 1.17, 9.08 P: 0.024], comorbidity [AOR =2.29, 95% CI: 1.24, 4.24, P: 0.008], polypharmacy [AOR = 2.54, 95% CI: 1.35, 4.76, P: 0.004], and Antipsychotic Polypharmacy (APP) [AOR = 2.15, 95% CI: 1.21, 3.82, P: 0.009] were significantly associated with ACB. Conclusion: In this study, one-third of patients were exposed to high ACB. Old aged patients, those with comorbidity, polypharmacy, and APP need routine follow-up and screening in order to reduce high anticholinergic exposure.