The effect of polypharmacy on quality of life in adult patients with nonalcoholic fatty liver disease in the United States

Prevalence and global trends of polypharmacy in patients with chronic Liver disease: a systematic review and meta-analysis

“…Until recently (Danjuma et al; in press), uncertainty still subsists regarding even the numerical threshold for what exactly constitutes polypharmacy amongst patients with CLD. Whilst a threshold of greater than 5 medications used in the de nition of polypharmacy in the general population has since been adopted by some reports in de ning polypharmacy amongst patients with CLD (7,5); other studies have raised concerns regarding the discriminant value of this numerical threshold that includes both liver-speci c and other general medications (Danjuma MI 2022;in press). It is our opinion that restricting the numerical count to non-liver related therapeutics will more robustly identify inappropriate medical burden, which has consistently been associated with worse clinical outcomes including death across clinical risks and patient populations (28).…”

“…Thereafter (n = 27) potentially relevant studies were selected for full text review; of which Seven studies (15) (7) (5)(16) (10) (17,18) inclusion for the systematic review and meta-analysis. The composition of the data source of the reviewed studies ranged from community primary carebased electronic longitudinal patient records (15) (10) ( 16), multicentre linked NAFLD registries (7), and University/tertiary hospital records (5) (Table 1). The reviewed studies were distributed across 4 continents with one study conducted in Australia (15), two in Iran (17) (18), one in the United Kingdom (UK) (( 10), Qatar (19), Spain (( 16), and the United States of America ( 7) each.…”

“…The underlying primary liver disease phenotype amongst the reviewed studies was variable. Patel et al (15) and Alrasheed et al (7) for example explored exclusively NAFLD patients; or be it with different diagnostic criteria for inclusion in their various studies. Soly-Bori et al reported on a wide variety of patient population with different clinical risks pro le (10).…”

“…Additionally, it remains uncertain if the primary liver disease phenotype (such as non-alcoholic fatty liver disease [NAFLD], Hepatitic cirrhosis etc) does have any signi cant impact on these estimates. A few of the studies that have explored polypharmacy in patients with CLD have included exclusively non-alcoholic fatty liver disease (NAFLD) patients (7) (8) In this report, we have carried out a systematic review and a meta-analysis of the prevalence of polypharmacy in patients with CLD as well as a comprehensive synthesis of socio-demographic factors that drive this.…”

Polypharmacy in patients with chronic liver disease: a systematic review of definitions

“…Baseline characteristics of the studies included in the review is given in Table 1. The constituent patient population of the included studies range from hospital-based cohorts (16-18) to community primary care databases (19)(20)(21). The geographical distribution of the countries where the reviewed studies were carried out is shown in Fig.…”