老年人的处方药和非处方药负担及其与健康相关生活质量的关联：一项横断面研究。
Prescription and Non-prescription Medication Pill Burdens and Their Associations with Health-Related Quality of Life in Older Adults: A Cross-Sectional Study.
作者信息
Vonderhaar Josephine M, Ernst Michael E, Fravel Michelle A, Orchard Suzanne G, Owen Alice J, Woods Robyn L, Wolfe Rory, Stocks Nigel, Gilmartin-Thomas Julia
机构信息
Department of Pharmacy Practice and Science, College of Pharmacy, The University of Iowa, 180 S. Grand Ave, Iowa City, IA, 52242, USA.
School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.
出版信息
Drugs Aging. 2025 May;42(5):457-467. doi: 10.1007/s40266-025-01199-0. Epub 2025 Mar 19.
BACKGROUND
Polypharmacy is associated with reduced health-related quality of life (HRQoL). This study explores the association between prescription and non-prescription medication pill burdens, independent of underlying morbidity, on HRQoL in an older adult population.
METHODS
Data from the final intervention year of the ASPirin in Reducing Events in the Elderly (ASPREE) randomized trial in older adults from Australia and the USA, were analyzed cross-sectionally. Participants reported daily prescription and non-prescription pill counts at the final trial visit. HRQoL was assessed using the 12-Item Short-Form instrument (SF-12) and summarized into the physical component summary (PCS) score and mental component summary (MCS) score, where lower scores reflect poorer HRQoL. Multivariable regression, adjusted for covariates, was used to examine the relationships of categorized prescription and non-prescription pill counts with PCS and MCS separately.
RESULTS
15,165 participants responded to the question about prescription use and 15,727 for non-prescriptions (mean age = 80 years). Compared with non-users of prescription medications, lower mean PCS scores and larger reductions in scores were seen as prescription medication pill burden increased from 1-3, 4-6, 7-9, to ≥ 10 pills (- 1.7, - 4.5, - 7.6, and - 10.9, respectively, p < 0.001). A similar relationship, but of lesser magnitude, was observed with non-prescription medication pill burden, where the mean PCS was lower by - 0.2 for 1-3 pills (p = 0.494), - 1.8 for 4-6 (p < 0.001), and - 1.9 for ≥ 7 pills (p < 0.001), compared with non-users. No significant association was observed between prescription or non-prescription medication pill burdens and MCS.
CONCLUSIONS
Prescription and non-prescription medication pill burdens are independently associated with reduced physical, but not mental, HRQoL in older adults.
背景
多重用药与健康相关生活质量（HRQoL）降低有关。本研究探讨了在老年人群体中，无论潜在发病率如何，处方药和非处方药的 pill 负担与 HRQoL 之间的关联。
方法
对澳大利亚和美国老年人进行的阿司匹林减少老年人事件（ASPREE）随机试验最后干预年的数据进行横断面分析。参与者在试验最后访视时报告每日处方药和非处方药的 pill 数量。使用 12 项简短量表（SF-12）评估 HRQoL，并汇总为身体成分汇总（PCS）得分和精神成分汇总（MCS）得分，得分越低表明 HRQoL 越差。使用针对协变量进行调整的多变量回归分别检查分类的处方药和非处方药 pill 数量与 PCS 和 MCS 之间的关系。
结果
15165 名参与者回答了关于处方药使用的问题，15727 名回答了关于非处方药的问题（平均年龄 = 80 岁）。与未使用处方药的人相比，随着处方药 pill 负担从 1 - 3、4 - 6、7 - 9 增加到≥10 片，平均 PCS 得分降低，且得分下降幅度更大（分别为 -1.7、-4.5、-7.6 和 -10.9，p < 0.001）。在非处方药 pill 负担方面观察到类似关系，但程度较小，与未使用者相比，1 - 3 片时平均 PCS 低 -0.2（p = 0.494），4 - 6 片时低 -1.8（p < 0.001），≥7 片时低 -1.9（p < 0.001）。未观察到处方药或非处方药 pill 负担与 MCS 之间存在显著关联。
结论
处方药和非处方药 pill 负担与老年人身体 HRQoL 降低独立相关，但与精神 HRQoL 无关。
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