患有长期疾病的社区居住成年人中与药物相关负担生活质量（MRB-QoL）相关的因素：一项探索性研究。
Factors Associated with Medication-Related Burden Quality of Life (MRB-QoL) in Community-Dwelling Adults with Long-Term Conditions: An Exploratory Study.
作者信息
Mohammed Mohammed A, Moles Rebekah J, Chen Timothy F
机构信息
University of Auckland, School of Pharmacy, Auckland, New Zealand.
The University of Sydney, School of Pharmacy, Sydney, NSW, Australia.
出版信息
Patient Relat Outcome Meas. 2021 Mar 2;12:55-63. doi: 10.2147/PROM.S245534. eCollection 2021.
BACKGROUND
The Medication-Related Burden Quality of Life (MRB-QoL) tool has been developed to measure the burden of medications on functioning and wellbeing from a patient perspective. However, predictors of MRB-QoL were not reported in greater detail in the validation study. This study aimed to explore factors associated with MRB-QoL to see whether there is any new information that calls for further research.
METHODS
Analysis of data from the MRB-QoL validation study was undertaken. Outcome variables were domains of the MRB-QoL (Routine and Regimen Complexity, Psychological Burden, Functional and Role Limitation, Therapeutic Relationship, and Social Burden). Explanatory variables were patient age; disease-related factors; and medication-related factors, such as number of medications, complexity of medication regimen (measured by the Medication Regimen Complexity Index [MRCI]), and exposure to medications with anticholinergic and sedative effects (measured by the Drug Burden Index [DBI]). Linear regression analyses were used to identify factors associated with the MRB-QoL.
RESULTS
The study included 367 participants (52.1% male), with a median age of 64 years. In multivariable regression analyses, an increase in the DBI was significantly associated with poorer Psychological wellbeing (=-0.15, <0.001) and Functional and Role Limitation (=-1.79, <0.001). Living with three or more medical conditions was significantly associated with poorer Psychological wellbeing (=-0.21, <0.001). Age was significantly associated with all domains of the MRB-QoL (=0.28 to 0.55). Polypharmacy and MRCI were not associated with any of the MRB-QoL domains.
CONCLUSION
In this sample of community-dwelling adults with multiple medications, the DBI was independently associated with the Psychological Burden and Functional and Role Limitation domains of the MRB-QoL. This study provides preliminary evidence on factors affecting medication-related quality of life outcomes from a patient perspective. Future longitudinal studies, along with further psychometric testing of the MRB-QoL measure, are warranted to better understand predictors of MRB-QoL.
背景
药物相关负担生活质量（MRB-QoL）工具已被开发出来，用于从患者角度衡量药物对功能和幸福感的负担。然而，在验证研究中，并未更详细地报告MRB-QoL的预测因素。本研究旨在探索与MRB-QoL相关的因素，以查看是否有任何新信息需要进一步研究。
方法
对MRB-QoL验证研究中的数据进行分析。结果变量为MRB-QoL的各个领域（日常和治疗方案复杂性、心理负担、功能和角色限制、治疗关系以及社会负担）。解释变量包括患者年龄；疾病相关因素；以及药物相关因素，如药物数量、药物治疗方案复杂性（通过药物治疗方案复杂性指数[MRCI]衡量），以及暴露于具有抗胆碱能和镇静作用的药物（通过药物负担指数[DBI]衡量）。采用线性回归分析来确定与MRB-QoL相关的因素。
结果
该研究纳入了367名参与者（52.1%为男性），中位年龄为64岁。在多变量回归分析中，DBI的增加与较差的心理健康（β=-0.15，P<0.001）以及功能和角色限制（β=-1.79，P<0.001）显著相关。患有三种或更多种疾病与较差的心理健康显著相关（β=-0.21，P<0.001）。年龄与MRB-QoL的所有领域均显著相关（β=0.28至0.55）。多重用药和MRCI与MRB-QoL的任何领域均无关联。
结论
在这个使用多种药物的社区居住成年人样本中，DBI与MRB-QoL的心理负担以及功能和角色限制领域独立相关。本研究从患者角度提供了影响药物相关生活质量结果的因素的初步证据。未来有必要进行纵向研究，并对MRB-QoL测量进行进一步的心理测量测试，以更好地理解MRB-QoL的预测因素。
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