Association between drug prescribing and quality of life in primary care

Abstract

Objective: To evaluate quality of life among patients of Family Health Strategy Units and how it relates to the prescribing complexity and to the number of psychotropic medications prescribed, including adjustments for sociodemographic characteristics.

Setting: Family Health Strategy Units in a municipality in the Brazilian state of Rio Grande do Sul.

Method: Cross-sectional study using face-to-face interviews and prescribing analysis among users of Family Health Strategy Units. Patients were recruited by consecutive sampling. Multiple linear regression models were fitted to the different domains of quality of life in the WHOQOL-Bref questionnaire. The response rate for the patients who completed the interview was 97%. The prescribed medication data and sociodemographic characteristics of the sample were included as covariates. Prescribing complexity was analyzed by means of the Medication Regimen Complexity Index. The assumptions in the estimated models were tested and the models were validated.

Main outcome measure: Quality of life among patients of Family Health Strategy Units.

Results: At total, 336 patients answered the questionnaire. Through multiple linear regression, it was observed that higher prescribing complexity was associated with significantly low scores in the physical (-2.01, 95% CI = -2.89 to -1.35) and overall (-1.93, 95% CI = -2.81 to -0.99) quality of life domains. Greater amounts of psychotropic medications prescribed were associated with significantly low scores in the physical (-1.02, 95% CI = -1.29 to -0.56), psychological (-2.52, 95% CI = -3.15 to -1.65) and overall (-0.97, 95% CI = -2.06 to -0.33) domains of the interviewees' quality of life. The estimated models were adjusted for the sociodemographic characteristics of the sample and presented good predictive capacity.

Conclusions: The evaluated aspects of the prescribed medication (complexity and presence of psychotropic medications) were associated with low scores in the physical, psychological and overall quality of life domains. This may be an intrinsic characteristic of the interviewed patients, like having the quality of life at such a low level before starting the treatment, that the medication could not improve it to normal levels. Also, it can be a demonstration of the ineffectiveness of these treatments within primary health care.