Potentially inappropriate medications use and its association with health-related quality of life among elderly cardiac patients

Qual Life Res. 2020 Oct;29(10):2715-2724. doi: 10.1007/s11136-020-02530-5. Epub 2020 May 20.

Abstract

Background: 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.

Objective: This study aimed to determine the association between PIMs use and HRQoL among elderly cardiac outpatients.

Method: 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 χ2 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.

Results: 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].

Conclusion: 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.

Keywords: Cardiovascular disease; Elderly; Health related quality of life; Patient safety; Potentially inappropriate medications.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Cross-Sectional Studies
  • Female
  • Heart Diseases / drug therapy*
  • Humans
  • Inappropriate Prescribing / trends*
  • Male
  • Potentially Inappropriate Medication List / trends*
  • Quality of Life / psychology*