Community pharmacists' knowledge of, and role in, managing anticholinergic burden among patients with dementia in primary care: a cross-sectional survey study.

Abstract

Background: Anticholinergic medications and associated anticholinergic burden can impair cognitive function and increase mortality rates in patients with dementia.

Aim: To explore community pharmacists' knowledge of anticholinergic burden and perceptions of their role in anticholinergic burden management amongst patients with dementia.

Method: A self-administered, postal questionnaire was distributed to all registered community pharmacies in Northern Ireland (n = 526) on two occasions (October and November 2022). The questionnaire comprised four sections: (1) demographics associated with pharmacists and pharmacies, (2) contact between community pharmacists and patients with dementia/their carers, and types of medication-related queries received by pharmacists, (3) understanding and knowledge about anticholinergic burden, and (4) community pharmacist role in management of anticholinergic burden in patients with dementia. Data were analysed descriptively using Stata v17.

Results: A response rate of 15.2% (80/526) was achieved. Most contact was with patients with dementia/carers in their own homes. Community pharmacists lacked knowledge about anticholinergic burden in dementia, did not use any anticholinergic burden scales in their practice (n = 77, 96.3%), and rarely discussed anticholinergic burden with patients, carers (n = 60, 75.0%), or other healthcare professionals (n = 42, 52.5%). However, they were positive about their role in future interventions and saw value in managing anticholinergic burden in patients with dementia as part of a multidisciplinary primary healthcare team (n = 67; 83.3%).

Conclusion: Despite the low response rate, the study findings have highlighted community pharmacists' willingness to contribute to the management of anticholinergic burden in patients with dementia. Further research is required to understand how this can be achieved.