Polypharmacy and Health-Related Quality of Life/Psychological Distress Among Patients With Chronic Disease

Abstract

Introduction To date, no study has investigated the impact of polypharmacy (use of ≥5 medications concurrently) on health-related quality of life (HRQOL) and psychological distress in a combined sample of chronic disease patients and patients with multimorbidity, using diverse HRQOL measures. This study aimed to explore the association between polypharmacy and HRQOL/psychological distress by using data from a cross-sectional study in Flanders (Belgium). Methods We analyzed cross-sectional survey data on 544 chronically ill patients recruited from June 2019 through June 2021. HRQOL was measured with the EuroQol-5 Dimension-5 Level questionnaire (EQ-5D-5L) and the 12-Item Short Form Health Survey (SF-12); psychological distress was measured with the Hospital Anxiety and Depression Scale (HADS). Multiple linear regression models were built to assess the association between polypharmacy and HRQOL/psychological distress. Results Overall, compared with patients without polypharmacy, patients with polypharmacy reported worse EQ-5D-5L index values, EuroQol visual analogue scale (EQ-VAS) scores, SF-12 physical component scores (PCS), SF-12 mental component scores (MCS), and HADS anxiety and depression subscales. In the final regression model adjusting for age, sex, educational attainment, and multimorbidity, polypharmacy remained significantly associated with lower HRQOL in terms of the EQ-5D-5L index (β = −0.12; P = .008), EQ-VAS (β = −0.11; P = .01), and SF-12 PCS (β = −0.15; P = .002) but not with psychological distress (HADS) and SF-12 MCS. Conclusion This study found that polypharmacy was negatively associated with the physical domain of HRQOL, but not with the mental domain, among patients with chronic diseases. These results may be especially important for patients with multimorbidity, given their greater risk of polypharmacy.

Differences in healthcare service utilization in patients with polypharmacy according to their risk level by adjusted morbidity groups: a population-based cross-sectional study

“…Younger patients and males showed higher levels of risk and complexity, probably because their severe conditions shortened their life expectancy and men have a shorter lifespan [ 21 ]. High-risk individuals generally presented increased ratios of functional impairment, consistent with previous studies [ 17 ]; however, the demand for a primary caregiver grew with the reduction in risk level, since the lack of this service could contribute to the increase in risk level, as observed in other studies [ 31 ].…”

Osteopathic manipulative treatment for chronic inflammatory diseases

“…Of note, polypharmacy in the setting of chronic disease is associated with reduced physical health-related quality of life. 38 Research indicates that adverse drug reactions impose a significant and growing health and financial burden on patients and healthcare systems. 39 Risks of adverse drug-drug or drug-disease interactions increase with each drug added to patient treatment regimen.…”

“…Indeed, people with chronic diseases, especially those with multimorbidity, are at increased risk for adverse drug reactions. Of note, polypharmacy in the setting of chronic disease is associated with reduced physical health‐related quality of life 38 . Research indicates that adverse drug reactions impose a significant and growing health and financial burden on patients and healthcare systems 39 .…”

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“…6 In addition to these findings, polypharmacy has also been negatively associated with the physical domain of the health-related quality of life (HRQOL) scale. 7 As regimens are more complex, studies have shown there is a correlation between this complexity and increased rates of nonadherence and hospitalization. 8 (Wimmer) On the other hand, there is also an association with community dwelling older adults and polypharmacy, showing a decline in cognitive ability.…”