Department of Public Health and Primary Care, Ghent University, University Hospital, Corneel Heymanslaan 10 4K3, 9000 Ghent, Belgium. Email:
Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium.
Prev Chronic Dis. 2022 Aug 18;19:E50. doi: 10.5888/pcd19.220062.
To date, no study has investigated the impact of polypharmacy (use of ≥5 medications concurrently) on health-related quality of life (HRQOL) and psychological distress in a combined sample of chronic disease patients and patients with multimorbidity, using diverse HRQOL measures. This study aimed to explore the association between polypharmacy and HRQOL/psychological distress by using data from a cross-sectional study in Flanders (Belgium).
We analyzed cross-sectional survey data on 544 chronically ill patients recruited from June 2019 through June 2021. HRQOL was measured with the EuroQol-5 Dimension-5 Level questionnaire (EQ-5D-5L) and the 12-Item Short Form Health Survey (SF-12); psychological distress was measured with the Hospital Anxiety and Depression Scale (HADS). Multiple linear regression models were built to assess the association between polypharmacy and HRQOL/psychological distress.
Overall, compared with patients without polypharmacy, patients with polypharmacy reported worse EQ-5D-5L index values, EuroQol visual analogue scale (EQ-VAS) scores, SF-12 physical component scores (PCS), SF-12 mental component scores (MCS), and HADS anxiety and depression subscales. In the final regression model adjusting for age, sex, educational attainment, and multimorbidity, polypharmacy remained significantly associated with lower HRQOL in terms of the EQ-5D-5L index (β = -0.12; P = .008), EQ-VAS (β = -0.11; P = .01), and SF-12 PCS (β = -0.15; P = .002) but not with psychological distress (HADS) and SF-12 MCS.
This study found that polypharmacy was negatively associated with the physical domain of HRQOL, but not with the mental domain, among patients with chronic diseases. These results may be especially important for patients with multimorbidity, given their greater risk of polypharmacy.
迄今为止，尚无研究使用多种健康相关生活质量（HRQOL）测量方法，在患有慢性病和多种疾病的患者的综合样本中调查同时使用≥5 种药物的多重用药（polypharmacy）对 HRQOL 和心理困扰的影响。本研究旨在使用来自比利时佛兰德地区（Flanders）的横断面研究数据来探讨多重用药与 HRQOL/心理困扰之间的关联。
我们分析了 2019 年 6 月至 2021 年 6 月期间招募的 544 名慢性病患者的横断面调查数据。HRQOL 使用欧洲五维健康量表-5 维问卷（EQ-5D-5L）和 12 项简明健康调查问卷（SF-12）进行测量；心理困扰使用医院焦虑抑郁量表（HADS）进行测量。建立多元线性回归模型来评估多重用药与 HRQOL/心理困扰之间的关联。
总体而言，与非多重用药患者相比，多重用药患者的 EQ-5D-5L 指数值、EQ-VAS 评分、SF-12 生理成分评分（PCS）、SF-12 心理成分评分（MCS）和 HADS 焦虑和抑郁子量表的报告结果更差。在最终的回归模型中，我们调整了年龄、性别、教育程度和多种合并症，发现多重用药与 HRQOL 的以下方面显著相关，包括 EQ-5D-5L 指数（β=-0.12；P=0.008）、EQ-VAS（β=-0.11；P=0.01）和 SF-12 PCS（β=-0.15；P=0.002），但与心理困扰（HADS）和 SF-12 MCS 无关。
本研究发现，在患有慢性病的患者中，多重用药与 HRQOL 的生理领域呈负相关，但与心理领域无关。鉴于多种合并症患者发生多重用药的风险更高，这些结果对于这些患者可能尤为重要。
