Department of Pharmacy, Quaid-I-Azam University, Islamabad, 45320, Pakistan.
College of Pharmacy, Jouf University, Sakaka, Aljouf, 72388, Saudi Arabia.
Qual Life Res. 2020 Oct;29(10):2715-2724. doi: 10.1007/s11136-020-02530-5. Epub 2020 May 20.
Previous studies identified alarming use of potentially inappropriate medications (PIMs) in Pakistani population but its effect on health-related quality of life (HRQoL) is still largely unknown.
This study aimed to determine the association between PIMs use and HRQoL among elderly cardiac outpatients.
A descriptive, non-experimental, cross-sectional study was carried out from June 2018 to September 2018 in two outpatient departments of tertiary-care hospitals in the Punjab Province of Pakistan. The population under study were patients aged ≥ 65 years with at least one cardiovascular condition taking at ≥ 1 prescribed medication. Patients with PIMs were identified by using Beers criteria. HRQoL was assessed using EuroQoL-5 dimension (EQ-5D) and EuroQoL-visual analogue scale (EQ-VAS). The association of PIMs with HRQoL was analyzed using χ tests, independent sample t-test, and one-way ANOVA tests. Multiple linear regression analysis was used to determine how HRQoL varied by PIMs use after adjusting for patient-level covariates.
Of 386 elderly cardiac patients, 260 (67.4%) patients were receiving at least one PIM. Mean EQ-5D scores were significantly lower among patients with PIMs (0.51) compared to patients without PIMs (0.65) (P < 0.001). In multiple linear regression analysis, increasing numbers of PIMs were significantly associated with lower EQ-5D scores [β = - 0.040 (- 0.075, - 0.005), P < 0.001] and VAS scores [β = - 1.686 (- 2.916, - 0.456), P < 0.05].
The present study concluded that exposure to PIM was significantly associated with lower HRQoL. This indicates that guidelines recommendations should be followed to improve patient's quality of life.
先前的研究已经确定了在巴基斯坦人群中存在令人担忧的潜在不适当药物（PIM）的使用情况，但它对健康相关生活质量（HRQoL）的影响在很大程度上仍然未知。
本研究旨在确定老年心脏门诊患者中 PIM 使用与 HRQoL 之间的关联。
本研究为 2018 年 6 月至 9 月期间在巴基斯坦旁遮普省两家三级医院的两个门诊部进行的描述性、非实验性、横断面研究。研究人群为年龄≥65 岁且至少有一种心血管疾病并服用≥1 种规定药物的患者。使用 Beers 标准确定 PIM 患者。使用欧洲五维健康量表（EQ-5D）和欧洲五维健康量表视觉模拟量表（EQ-VAS）评估 HRQoL。使用 χ2 检验、独立样本 t 检验和单因素方差分析检验 PIM 与 HRQoL 的关联。使用多元线性回归分析确定在调整患者水平协变量后，PIM 使用如何影响 HRQoL。
在 386 名老年心脏患者中，有 260 名（67.4%）患者至少使用了一种 PIM。与未使用 PIM 的患者相比，使用 PIM 的患者的平均 EQ-5D 评分明显更低（0.51 比 0.65，P<0.001）。在多元线性回归分析中，PIM 数量的增加与 EQ-5D 评分降低显著相关[β=-0.040（-0.075，-0.005），P<0.001]和 VAS 评分降低显著相关[β=-1.686（-2.916，-0.456），P<0.05]。
本研究表明，接触 PIM 与 HRQoL 降低显著相关。这表明应遵循指南建议以提高患者的生活质量。
