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.

中文翻译：

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从患者，护理人员和医护人员的角度来看，减少抗胆碱能负担的障碍和促进者：定性证据综合的方案。

开具抗胆碱能药物可用于多种疾病，包括胃肠道疾病，膀胱过度活动症，过敏和抑郁症。尽管在某些情况下抗胆碱作用是治疗性的，但它们也带来了许多不良或不利的影响。伴随使用多种具有抗胆碱能特性的药物的总体影响被称为抗胆碱能负担（ACB）。更高的ACB会增加身体和认知功能受损，跌倒，心血管事件和死亡率的风险。这导致了旨在通过停用抗胆碱能药物减少ACB的干预措施的开发。但是，对于可能影响此类干预措施成功嵌入和整合到常规临床实践中的实施问题知之甚少。在本文中，我们提出了用于系统评价的方案，旨在从患者，护理人员和医疗保健专业人员的角度确定降低ACB的障碍和促进因素的定性证据。将在OVID Medline，EMBASE，PsycInfo和CINAHL上进行全面的搜索策略。审查将根据ENTREQ（增强报告质量研究的透明度）进行，并已在PROSPERO注册（注册号CRD42018109084）。归一化过程理论（NPT）将用于探索，理解和解释与阻碍ACB减少的障碍或促进因素有关的定性数据。