Barriers and facilitators to reducing anticholinergic burden from the perspectives of patients, their carers, and healthcare professionals

A protocol for qualitative evidence synthesis

Carrie Stewart (Corresponding Author), Katie Gallacher, Athagran Nakham, Moira Cruickshank, Rumana Newlands, Christine Bond, Phyo K. Myint, Debi Bhattacharya, Frances S. Mair

Research output: Contribution to journalArticle

Abstract

Anticholinergic drugs are prescribed for a range of conditions including gastrointestinal disorders, overactive bladder, allergies, and depression. While in some circumstances anticholinergic effects are therapeutic, they also pose many undesired or adverse effects. The overall impact from concomitant use of multiple medications with anticholinergic properties is termed anticholinergic burden (ACB). Greater ACB is associated with increased risks of impaired physical and cognitive function, falls, cardiovascular events, and mortality. This has led to the development of interventions aimed at reducing ACB through the deprescribing of anticholinergic drugs. However, little is known about the implementation issues that may influence successful embedding and integration of such interventions into routine clinical practice. In this paper, we present the protocol for our systematic review that aims to identify the qualitative evidence for the barriers and facilitators to reduce ACB from the perspectives of patients, carers, and healthcare professionals. A comprehensive search strategy will be conducted across OVID Medline, EMBASE, PsycInfo, and CINAHL. The review will be conducted in accordance with ENTREQ (Enhancing Transparency in Reporting the Synthesis of Qualitative Research) and has been registered with PROSPERO (Registration CRD42018109084). Normalization process theory (NPT) will be used to explore, understand, and explain qualitative data in relation to factors that act as barriers or facilitators to ACB reduction.
Original languageEnglish
Pages (from-to)227-231
Number of pages5
JournalJournal of Evidence-Based Medicine
Volume12
Issue number3
Early online date22 Aug 2019
DOIs
Publication statusPublished - Aug 2019

Fingerprint

Cholinergic Antagonists
Caregivers
Delivery of Health Care
Overactive Urinary Bladder
Qualitative Research
Therapeutic Uses
Pharmaceutical Preparations
Cognition
Hypersensitivity
Depression
Mortality

Keywords

  • Anticholinergics
  • deprescribing
  • intervention development
  • qualitative research
  • systematic review

ASJC Scopus subject areas

  • Health Policy

Cite this

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title = "Barriers and facilitators to reducing anticholinergic burden from the perspectives of patients, their carers, and healthcare professionals: A protocol for qualitative evidence synthesis",
abstract = "Anticholinergic drugs are prescribed for a range of conditions including gastrointestinal disorders, overactive bladder, allergies, and depression. While in some circumstances anticholinergic effects are therapeutic, they also pose many undesired or adverse effects. The overall impact from concomitant use of multiple medications with anticholinergic properties is termed anticholinergic burden (ACB). Greater ACB is associated with increased risks of impaired physical and cognitive function, falls, cardiovascular events, and mortality. This has led to the development of interventions aimed at reducing ACB through the deprescribing of anticholinergic drugs. However, little is known about the implementation issues that may influence successful embedding and integration of such interventions into routine clinical practice. In this paper, we present the protocol for our systematic review that aims to identify the qualitative evidence for the barriers and facilitators to reduce ACB from the perspectives of patients, carers, and healthcare professionals. A comprehensive search strategy will be conducted across OVID Medline, EMBASE, PsycInfo, and CINAHL. The review will be conducted in accordance with ENTREQ (Enhancing Transparency in Reporting the Synthesis of Qualitative Research) and has been registered with PROSPERO (Registration CRD42018109084). Normalization process theory (NPT) will be used to explore, understand, and explain qualitative data in relation to factors that act as barriers or facilitators to ACB reduction.",
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author = "Carrie Stewart and Katie Gallacher and Athagran Nakham and Moira Cruickshank and Rumana Newlands and Christine Bond and Myint, {Phyo K.} and Debi Bhattacharya and Mair, {Frances S.}",
note = "ACKNOWLEDGMENTS This review is funded by The Dunhill Medical Trust (RPGF1806/66) as part of a series of work building an evidence synthesis suite to inform a future randomized trial of reducing anticholinergic related harm in older adults. The funding sponsors had no role in the design, execution, interpretation, or writing of the study.",
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AU - Bond, Christine

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AU - Bhattacharya, Debi

AU - Mair, Frances S.

N1 - ACKNOWLEDGMENTS This review is funded by The Dunhill Medical Trust (RPGF1806/66) as part of a series of work building an evidence synthesis suite to inform a future randomized trial of reducing anticholinergic related harm in older adults. The funding sponsors had no role in the design, execution, interpretation, or writing of the study.

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N2 - Anticholinergic drugs are prescribed for a range of conditions including gastrointestinal disorders, overactive bladder, allergies, and depression. While in some circumstances anticholinergic effects are therapeutic, they also pose many undesired or adverse effects. The overall impact from concomitant use of multiple medications with anticholinergic properties is termed anticholinergic burden (ACB). Greater ACB is associated with increased risks of impaired physical and cognitive function, falls, cardiovascular events, and mortality. This has led to the development of interventions aimed at reducing ACB through the deprescribing of anticholinergic drugs. However, little is known about the implementation issues that may influence successful embedding and integration of such interventions into routine clinical practice. In this paper, we present the protocol for our systematic review that aims to identify the qualitative evidence for the barriers and facilitators to reduce ACB from the perspectives of patients, carers, and healthcare professionals. A comprehensive search strategy will be conducted across OVID Medline, EMBASE, PsycInfo, and CINAHL. The review will be conducted in accordance with ENTREQ (Enhancing Transparency in Reporting the Synthesis of Qualitative Research) and has been registered with PROSPERO (Registration CRD42018109084). Normalization process theory (NPT) will be used to explore, understand, and explain qualitative data in relation to factors that act as barriers or facilitators to ACB reduction.

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