Keywords: polypharmacy, quality of life, predictors of polypharmacy

Background:

Polypharmacy is an important public health problem due to its potential negative effects on individual health. It is associated with many risk determinants

Research questions:

Do Risk Determinants Affect Polypharmacy and Does Polypharmacy Affect the Variability of Quality of Life and Self-Assessed Health?

Method:

It was a multicenter prospective randomized clinical study, conducted over 12 months in 2022/2023 on 174 respondents older than 65 years with multimorbidity and polypharmacy in 8 primary care clinics. A standard questionnaire was analyzed; correlation of polypharmacy and quality of life assessment was conducted.

Results:

Sperman's non-parametric correlation did not indicate a significant individual association between polypharmacy with each of the selected parameters such as gender, age groups, education, place of residence and GFR. Multiple regression analysis confirmed 5 parameters (number of chronic diseases, number of risk factors, number of risk habits, OTC and BMI) as independent significant predictors of polypharmacy. These 5 parameters as independent significant predictors together affect the variability of polypharmacy [F (5, 337) = 43.202] in 39.1% (R2 = 0.391; p = 0.010). Polypharmacy, as an individual predictor, significantly affects the variability of quality of life (EQ-5D-5L) in 8.5% (R2 = 0.085; p = 0.0001). Increasing the number of medications (polypharmacy) for one drug on average reduces the quality of life by 0.157. Polypharmacy, as an individual predictor, significantly affects the variability of the health status assessment (EQWAS) by 3.6% (R2=0.036; p=0.0001). Increasing the number of medications (polypharmacy) for one medication on average reduces the assessment of the current health status by 0.022.

Conclusions:

In our country, there is no accurate data on how much patients' medications affect their quality of life. The research has shown that only five independent significant predictors together affect the variability of polypharmacy, which reduces the quality of life and self-assessed health.

Points for discussion: