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


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
Issue number3
Early online date22 Aug 2019
Publication statusPublished - Aug 2019



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

ASJC Scopus subject areas

  • Health Policy

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