Polypharmacy and Anticholinergic Burden in Hospitalised Older Patients - A Cross Sectional Audit

Abstract

Objectives: To investigate the impact of hospital admission on polypharmacy and anticholinergic burden and explore doctors’ awareness of cognitive side effects of anticholinergics use. Methods:A cross sectional retrospective audit of older patients admitted to a care of elderly ward over three months. We have collected patients’ demographic data, number of medications and anticholinergic burden scale on admission compared to on discharge and investigated doctors’ knowledge about polypharmacy by answering a questionnaire. Results: 100 patients were included. Mean number of medications and anticholinergic burden were significantly higher on discharge compared to admission (9.43 v.8.27, p<0.001 and 1.50 v. 1.30, p<0.01, re4spectively). Seven doctors (25%) had no knowledge of any anticholinergic medications at all. Only 16 (57%) doctors were aware of the negative impact of this class of medications on cognitive function and 22 (79%) doctors felt not at all confident in identifying or reducing anticholinergic prescriptions for inpatients. Conclusion:Hospitalisation results in a significant increase in polypharmacy and anticholinergic burden in older people and doctors’ knowledge of the cognitive risks associated with anticholinergic medications in older people is poor.