Zhang Sha, Meng Long, Qiu Feng, Yang Jia-Dan, Sun Shusen
Department of Pharmacy, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People's Republic of China.
Department of Pharmacy Practice, College of Pharmacy and Health Sciences, Western New England University, Springfield, MA, USA.
Patient Prefer Adherence. 2018 Apr 10;12:529-537. doi: 10.2147/PPA.S156713. eCollection 2018.
Previous studies have demonstrated that medication adherence has an impact on health-related quality of life (HRQoL). However, other medication-related factors that may influence HRQoL have not been extensively studied, especially factors based on the Medication-Risk Questionnaire (MRQ), and such studies are mostly done in Western countries. Our objective was to explore risk factors associated with HRQoL among community-dwelling elderly with chronic diseases in mainland China, especially the medication-related risk factors regarding MRQ.
The study was conducted in a community health service center through surveys to eligible patients. The main outcomes of HRQoL were assessed by the EuroQol-5D (EQ-5D) scale and EQ-visual analog scale (EQ-VAS). Medication-related risk factors according to MRQ associated with HRQoL were identified using a multiple linear regression.
A total of 311 patients were analyzed, averaging 71.19±5.33 years, and 68.8% were female. The mean EQ-5D index was 0.72±0.09, and the mean EQ-VAS score was 71.37±11.97. The most prevalent problem was pain/discomfort, and 90.0% believed that they could take care of themselves without any problems. Sex, age, educational level, frailty, function status, and certain medication-related factors regarding MRQ were found to be significant factors impacting the HRQoL. A multivariate analysis showed that MRQ factors of polypharmacy, multimorbidity, feeling difficultly with taking medicines as prescribed, and taking medicines with narrow therapeutic index had negative impacts on the quality of life.
Patient's internal characteristics and medication-related risk factors according to MRQ were associated with quality of life. The results of the MRQ is an indicator of quality of life that can identify patients who need interventions.
先前的研究表明，药物依从性对健康相关生活质量（HRQoL）有影响。然而，其他可能影响HRQoL的药物相关因素尚未得到广泛研究，尤其是基于药物风险问卷（MRQ）的因素，且此类研究大多在西方国家进行。我们的目的是探讨中国大陆社区慢性病老年患者中与HRQoL相关的危险因素，尤其是与MRQ相关的药物相关危险因素。
该研究在社区卫生服务中心对符合条件的患者进行调查。HRQoL的主要结局通过欧洲五维度健康量表（EQ-5D）和EQ视觉模拟量表（EQ-VAS）进行评估。使用多元线性回归确定与HRQoL相关的根据MRQ的药物相关危险因素。
共分析了311例患者，平均年龄为71.19±5.33岁，女性占68.8%。EQ-5D指数的平均值为0.72±0.09，EQ-VAS评分的平均值为71.37±11.97。最普遍的问题是疼痛/不适，90.0%的人认为他们能够自理且没有任何问题。性别、年龄、教育水平、虚弱、功能状态以及某些与MRQ相关的药物相关因素被发现是影响HRQoL的重要因素。多因素分析表明，MRQ中多重用药、多病共存、难以按规定服药以及服用治疗指数窄的药物等因素对生活质量有负面影响。
患者的内在特征和根据MRQ的药物相关危险因素与生活质量相关。MRQ的结果是生活质量的一个指标，可识别需要干预的患者。
