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. 2024 Dec;15(6):1713-1723.
doi: 10.1007/s41999-024-01036-4. Epub 2024 Aug 20.

The association between medication use and health-related quality of life in multimorbid older patients with polypharmacy

Charlotte Falke  1 , Fatma Karapinar  2   3 , Marcel Bouvy  4 , Mariëlle Emmelot  5 , Svetlana Belitser  4 , Benoit Boland  6   7 , Denis O'Mahony  8   9 , Kevin D Murphy  10 , Moa Haller  11   12 , Paola Salari  13   14 , Matthias Schwenkglenks  13 , Nicolas Rodondi  11   12 , Toine Egberts  4 , Wilma Knol  5
Affiliations

The association between medication use and health-related quality of life in multimorbid older patients with polypharmacy

Charlotte Falke et al. Eur Geriatr Med. 2024 Dec.

Erratum in

Abstract

Purpose: To explore the association between medication use-related factors and health-related quality of life (HRQoL) in older hospitalised multimorbid patients with polypharmacy.

Methods: This cross-sectional study used the intervention arm data of the OPERAM trial (hospitalised patients ≥ 70 years with polypharmacy). HRQoL was assessed using the visual analogue scale (EQ-VAS) and the EQ-5D index score of the EuroQol questionnaire (EQ-5D-5L). Lower or higher EQ-VAS/EQ-5D was based on the median of the study population. Medication use-related factors included hyperpolypharmacy (≥ 10 medications), anticholinergic and sedative burden, appropriateness of medication (STOPP/START criteria), high-risk medication for hospital (re)admission, medication complexity and adherence. Multivariable logistic regression analysis was used to assess the association between medication use-related factors and HRQoL.

Results: A total of 955 patients were included (mean age 79 years, 46% female, median EQ-VAS of 60, median EQ-5D of 0.60). Opioids use was associated with lower EQ-5D and EQ-VAS (aOR EQ-5D: 2.10; 95% CI 1.34-3.32, EQ-VAS: 1.59; 1.11-2.30). Hyperpolypharmacy (aOR 1.37; 1.05-1.80), antibiotics (aOR 1.64; 1.01-2.68) and high medication complexity (aOR 1.53; 1.10-2.15) were associated with lower EQ-VAS. A high anticholinergic and sedative burden (aOR 1.73; 1.11-2.69), presence of multiple prescribing omissions (aOR 1.94; 1.19-3.17) and benzodiazepine use (aOR 2.01; 1.22-3.35) were associated with lower EQ-5D. Especially in hyperpolypharmacy patients, high anticholinergic and sedative burden and medication complexity were associated with a lower HRQoL.

Conclusion: Several medication use-related factors are significantly associated with a lower HRQoL in hospitalised older patients. Medication complexity is a novel factor, which should be considered when evaluating medication use of older patients with hyperpolypharmacy.

Keywords: HRQoL; Medication complexity; Medication use; Polypharmacy; Quality of life.

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Conflict of interest statement

Declarations. Conflict of interest: On behalf of all authors, the corresponding author states that there is no conflict of interest. Ethical approval: Ethical approval for the OPERAM study protocol was obtained from the local ethics committee at each participating trial site and registered under trial registration number NCT02986425. As this study used the same data, no additional ethical approval was needed. Informed consent: Informed consent was obtained from all individual participants, or a proxy in case of cognitive impairment, included in this study.

Figures

Fig. 1
Fig. 1
Scatter plot depicting the nonlinear association of EQ-VAS and EQ-5D index scores of the study population at baseline
See this image and copyright information in PMC

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