Montiel-Luque Alonso, Núñez-Montenegro Antonio Jesús, Martín-Aurioles Esther, Canca-Sánchez Jose Carlos, Toro-Toro Maria Carmen, González-Correa José Antonio
San Miguel Health Center, Costa del Sol Primary Healthcare District, Andalusian Health Service, Málaga, Spain.
North Málaga Health Area, Andalusian Health Service, Málaga, Spain.
PLoS One. 2017 Feb 6;12(2):e0171320. doi: 10.1371/journal.pone.0171320. eCollection 2017.
Objective: To describe the relationship between medication-related factors and the health-related quality of life in patients older than 65 years who use multiple medications (polypharmacy). Design: Cross-sectional descriptive study. Setting: Primary care. Participants: Patients older than 65 years who use multiple medications (n = 375). Measurements: The main outcome measure was health-related quality of life according to the EuroQol-5D instrument. Sociodemographic, clinical and medication-related variables were recorded during home interviews.
Mean age was 74.72 ± 5.59 years, and 65.5% of our participants were women. The global level of health-related quality of life according to the EQ-5D visual analog scale was 59.25 ± 20.92. Of the five EuroQol dimensions, anxiety/depression and pain were the most frequently reported, while mobility and self-care were the dimensions with the greatest impact on self-reported quality of life. Multivariate analysis indicated that functional independence was the factor most strongly associated (β = 14.27 p < 0.001) with better health-related quality of life, while illiteracy (β = -13.58 p < 0.001), depression (β = -10.13 p < 0.001), social risk (β = -7.23 p = 0.004) and using more than 10 medicines (β = -4.85 p = 0.009) were strongly associated with a poorer health-related quality of life.
Factors inherent within the patient such as functional incapacity, cognitive impairment and social and emotional problems were the main constraints to quality of life in our study population. The number of medicines taken was negatively related with quality of life.
目的:描述使用多种药物(多重用药)的65岁以上患者中与药物相关因素和健康相关生活质量之间的关系。设计:横断面描述性研究。背景:初级保健。参与者:使用多种药物的65岁以上患者(n = 375)。测量:主要结局指标是根据欧洲五维健康量表(EuroQol-5D)得出的健康相关生活质量。在家庭访谈期间记录社会人口统计学、临床和与药物相关的变量。
平均年龄为74.72±5.59岁,65.5%的参与者为女性。根据EQ-5D视觉模拟量表得出的健康相关生活质量总体水平为59.25±20.92。在欧洲五维健康量表的五个维度中,焦虑/抑郁和疼痛是报告最频繁的维度,而活动能力和自我护理是对自我报告的生活质量影响最大的维度。多变量分析表明,功能独立性是与更好的健康相关生活质量最密切相关的因素(β = 14.27,p < 0.001),而文盲(β = -13.58,p < 0.001)、抑郁(β = -10.13,p < 0.001)、社会风险(β = -7.23,p = 0.004)和使用超过10种药物(β = -4.85,p = 0.009)与较差的健康相关生活质量密切相关。
患者自身的因素,如功能丧失、认知障碍以及社会和情感问题是我们研究人群生活质量的主要限制因素。所服用药物的数量与生活质量呈负相关。