What question did this study set out to answer?

To evaluate the prevalence and predictors of polypharmacy and anticholinergic burden in urology patients.

March 30, 2026Indian Journal of Urology0 citationsOpen Access

Anticholinergic burden and polypharmacy in hospitalized urology patients: Prevalence and clinical implications

EOErdem OrmanRecep Tayyip Erdoğan University HUHakki UzunRecep Tayyip Erdoğan University GAGörkem AkçaRecep Tayyip Erdoğan University

Key Points

To evaluate the prevalence and predictors of polypharmacy and anticholinergic burden in urology patients.
Conducted a retrospective cohort study of 500 hospitalized patients in a urology department
Extracted data from electronic medical records, including demographics and medications
Defined polypharmacy as ≥5 concurrent medications and assessed anticholinergic burden using ACB Scale.
40.6% of patients experienced polypharmacy, particularly in those ≥50 years (47.1%)
Anticholinergic medications were prescribed to 71.4% of patients; 25.6% were classified as high-risk (ACB ≥3)
Older age correlated with higher ACB scores; no significant sex differences observed.

Abstract

ABSTRACT Background: The increasing prevalence of polypharmacy and cumulative anticholinergic burden (ACB) in hospitalized patients represents a major concern for drug safety and pharmacological risk management. This study evaluated the prevalence and predictors of polypharmacy and ACB in urology inpatient population, with a focus on pharmacological classification of anticholinergic exposure. Materials and Methods: A retrospective cohort study was conducted among 500 consecutive patients admitted to a tertiary urology department between September 2024 and March 2025. Data were extracted from the electronic medical records, including demographics, clinical diagnoses, and prescribed medications. Polypharmacy was defined as ≥5 concurrent medications. Anticholinergic burden was assessed using the Anticholinergic Cognitive Burden (ACB) Scale, with scores ≥3 considered high risk. Results: The cohort had a mean age of 61.7 ± 14.2 years and was predominantly male (81.6%). Polypharmacy was observed in 40.6% of the patients, with significantly higher prevalence in those ≥50 years (47.1% vs. 9.3%; odds ratio = 6.88, 95% confidence interval: 4.09–18.43). Anticholinergic medications were prescribed to 71.4% of the patients, with 25.6% classified as high-risk (ACB ≥3). Pharmacological subgroup analysis revealed frequent exposure to cardiovascular, psychotropic, neurological, and urological agents with anticholinergic properties. Older age was associated with higher ACB scores ( P = 0.043). No significant sex differences were observed in the prevalence of polypharmacy ( P = 0.06) or ACB burden ( P > 0.05). Conclusions: Urology inpatients, particularly older adults, demonstrate high rates of polypharmacy and pharmacologically significant anticholinergic exposure. These findings underscore the importance of pharmacological vigilance, rational prescribing, and deprescribing strategies to mitigate drug-related adverse outcomes in hospitalized population.

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