Abstract

Multiple co-morbidities and polypharmacy in geriatric patients are difficult to treat. Medications with anticholinergic burden characteristics are highly prescribed in this population, resulting in cognitive impairments, poor outcomes, and increased healthcare costs. So, we aimed to determine the magnitude of the anticholinergic burden in geriatric patients using the anticholinergic cognitive burden (ACB) scale and its impact on treatment compliance. A prospective observational study of 350 geriatric patients was conducted in the medicine department of a tertiary care hospital. Inpatients aged ≥60 years were included. Anticholinergic burden was assessed using the ACB scale, and medication adherence was evaluated using the Morisky Medication Adherence Scale. A follow-up of 50 randomly selected patients was conducted to assess the impact of patient counselling on treatment compliance. Of the 350 geriatric patients included, 255 (72.85%) received anticholinergic medications, with 140 (40%) having an ACB score ≥3. A total of 22 anticholinergic medications were prescribed, with levocetirizine (22.82%), ranitidine (16.18%), and quetiapine (10.37%) being the most common. Cognitive impairment (29.02%), dizziness (18.82%), dry mouth (13.72%), and urinary incontinence (10.58%) were among the most reported adverse effects. Patients with a higher anticholinergic burden demonstrated lower adherence. Counselling during follow-up was associated with a notable improvement in treatment compliance. A high prevalence of anticholinergic medication use was observed in the geriatric population, often accompanied by adverse effects and poor adherence. Pharmacist-led counselling was found to significantly enhance medication compliance, highlighting its role in improving geriatric care outcomes.

Key words: Anticholinergic, adherence, counselling, geriatric, ACB.