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多发性骨髓瘤患者的健康相关生活质量和抗胆碱能药物的使用情况。

Health-related quality of life and use of medication with anticholinergic activity in patients with multiple myeloma.

机构信息

Departament of Social Pharmacy, Faculty of Pharmacy, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.

Departament of Social Pharmacy, Faculty of Pharmacy, Universidade Federal de Minas Gerais, Ezequiel Dias Foundation-Funed, Belo Horizonte, Minas Gerais, Brazil.

出版信息

Support Care Cancer. 2023 Jun 6;31(7):379. doi: 10.1007/s00520-023-07835-y.

Abstract

PURPOSE

Verify the association between anticholinergic burden and health-related quality of life of patients with multiple myeloma.

METHODS

Cross-sectional study with multiple myeloma outpatient from a state capital city in southeastern Brazil. Sociodemographic, clinical, and pharmacotherapeutic variables were collected by interview. Clinical data were complemented by medical records. Drugs with anticholinergic activity were identified with Brazilian Anticholinergic Activity Drug Scale. Health-related quality of life scores were obtained using QLQ-C30 and QLQ-MY20 instruments. Mann-Whitney was used to compare the median of the health-related quality of life scale scores and the independent variables. Multivariate linear regression was performed to verify the association between independent variables and health-related quality of life scores.

RESULTS

Two hundred thirteen patients were included, 56.3% had multi-morbidities, and 71.8% used polypharmacy. In all health-related quality of life domains, there were differences between the medians of the polypharmacy variable. A significant difference was identified between the ACh burden and QLQ-C30 and QLQ-MY20 scores. Linear regression identified an association between the use of drugs with anticholinergic activity and the reduction of global status scores (QLQ-C30), functional scale (QLQ-C30), body image (QLQ-MY20), and future perspective (QLQ-MY20). Drugs with anticholinergic activity were associated with increased symptom scores (QLQ-C30 and QLQ-MY20). Polypharmacy was associated with reduction of functioning score and increase of symptom score (QLQ-C30).

CONCLUSION

Anticholinergic burden in MM patients is associated with lower scores in quality of life domains: global health and symptoms (QLQ-C30) and functional (QLQ-C30 and QLQ-MY20). The presence of polypharmacy is also associated with lower scores for functional scales and symptom scales (QLQ-C30).

摘要

目的

验证多发性骨髓瘤患者抗胆碱能负担与健康相关生活质量之间的关联。

方法

这是一项来自巴西东南部州府城市的多发性骨髓瘤门诊患者的横断面研究。通过访谈收集社会人口统计学、临床和药物治疗变量。临床数据通过病历进行补充。使用巴西抗胆碱能活性药物量表识别具有抗胆碱能活性的药物。使用 QLQ-C30 和 QLQ-MY20 工具获得健康相关生活质量评分。采用 Mann-Whitney 检验比较健康相关生活质量量表评分和独立变量的中位数。进行多变量线性回归以验证独立变量与健康相关生活质量评分之间的关系。

结果

共纳入 213 名患者,56.3%有多发性疾病,71.8%使用多种药物。在所有健康相关生活质量领域,多药治疗变量的中位数存在差异。抗胆碱能负担与 QLQ-C30 和 QLQ-MY20 评分之间存在显著差异。线性回归确定了使用具有抗胆碱能活性的药物与全球状态评分(QLQ-C30)、功能量表(QLQ-C30)、身体形象(QLQ-MY20)和未来展望(QLQ-MY20)降低之间的关联。具有抗胆碱能活性的药物与症状评分增加(QLQ-C30 和 QLQ-MY20)相关。多药治疗与功能评分降低和症状评分增加相关(QLQ-C30)。

结论

多发性骨髓瘤患者的抗胆碱能负担与生活质量领域的评分降低相关:全球健康和症状(QLQ-C30)以及功能(QLQ-C30 和 QLQ-MY20)。多药治疗的存在也与功能量表和症状量表评分降低相关(QLQ-C30)。

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