Polypharmacy and Health-Related Quality of Life Among US Adults With Arthritis, Medical Expenditure Panel Survey, 2010–2012

Abstract

IntroductionOur objective was to determine the relationship between polypharmacy (treatment with prescription drugs from 6 or more drug classes concurrently) and health-related quality of life (HRQoL) among US adults with arthritis.MethodsWe conducted a retrospective cohort study that used 2-year longitudinal data from the Medical Expenditure Panel Survey to analyze a cohort of 6,132 adults aged over 21 years with arthritis. Measures of HRQoL were the summary scores from the mental component summary (MCS) and physical component summary (PCS) of the 12-item short-form health survey. Unadjusted and adjusted regression models were used to evaluate the association between polypharmacy and HRQoL measures. We used SAS, version 9.4, (SAS Institute Inc) to conduct all analyses.ResultsIn unadjusted analyses, adults with arthritis taking prescription drugs from 6 or more drug classes concurrently had significantly lower MCS and PCS scores (β, −3.11, P < .001 and β, −10.26, P < .001, respectively) than adults taking prescription drugs from fewer than 6. After controlling for the demographic characteristics, number of mental and physical chronic conditions, and baseline MCS and PCS scores, adults taking prescription drugs from 6 or more drug classes concurrently had significantly lower PCS scores (β, −1.68, P < .001), than those taking prescription drugs from fewer than 6. However, no significant difference in MCS scores was found between adults taking prescription drugs from 6 or more drug classes concurrently and those taking prescription drugs from fewer than 6 (β, −0.27, P = .46).ConclusionPolypharmacy is significantly associated with lower PCS scores among adults with arthritis. Because polypharmacy can lead to drug–drug and drug–disease interactions, health care providers need to consider the risk and adopt a cautious approach in prescribing multiple drugs to manage chronic conditions and in choosing therapies to improve HRQoL among adults with arthritis.

Health‐related quality of life and its associated factors among outpatients with osteoporosis

“…Consistent with the current study findings, earlier studies have also demonstrated an association between the increased number of prescribed medications and HRQoL . An earlier retrospective cohort study aimed to determine the association between polypharmacy and HRQoL among US adults with arthritis using the mental component summary (MCS) and physical component summary (PCS) scores found that adults with arthritis taking six or more medications concurrently were found to have significantly lower MCS and PCS scores than adults who were prescribed less than six medications . Another cross‐sectional descriptive study used the EQ‐5D to describe the association between medication‐related factors and HRQoL in patients older than 65 years found that patients who were using more than ten medicines were found to have poor HRQoL .…”

“…[23,24] An earlier retrospective cohort study aimed to determine the association between polypharmacy and HRQoL among US adults with arthritis using the mental component summary (MCS) and physical component summary (PCS) scores found that adults with arthritis taking six or more medications concurrently were found to have significantly lower MCS and PCS scores than adults who were prescribed less than six medications. [25] Another cross-sectional descriptive study used the EQ-5D to describe the association between medication-related factors and HRQoL in patients older than 65 years found that patients who were using more than ten medicines were found to have poor HRQoL. [26] The increased number of prescribed medications may lead to an increased risk of inappropriate medication use, under-use of effective treatments, medication errors, poor adherence, drug-drug and drug-disease interactions and most importantly increase the potential of medication side effects which could have a negative impact on HRQoL.…”

Automated Analysis of Polypharmacy using Prescription Drug Claims Data

“…The multiple faces for polypharmacy also involve considering the type of data or medical element used as basis for its definition. The literature involves some studies that used the actual number of drugs [1,2,4,7,17], and others that used the number of drug classes [18,19,20]. This makes a substantial difference for polypharmacy results.…”

“…Others used: 2 or more drugs, 3 or more, 5 or more, 6 or more, 10 or more, but the most common number used to define polypharmacy was 5. As reported in the literature, some studies used the actual drugs [1,2,4,7,17], while others used drug classes [18,19,20,21].…”

“…Defining polypharmacy based on the drug classes has been used in the literature for beneficial monitoring of patients' medications prescriptions and examining their safety at the drug-class level. See [18,19,20,21] for examples.…”