(AK) Polypharmacy and Trajectories of Health-Related Quality of Life in Older Adults: A National Cohort Study

Saturday, August 27, 2022

8:00 AM – 6:00 PM CEST

Location: Hall E South

Publication Number: 653

Presenting Author(s)

Edwin CK Tan, PhD
– The University of Sydney, New South Wales, Australia

Co-Author(s)

Muhamad Aljeaidi
– University of Western Australia, Australia
Miriam Haaksma
– Leiden University Medical Center, Netherlands

Background: Health-related quality of life (HRQoL) is an important outcome measure when considering medical treatment; however, the impact of polypharmacy on trajectories of HRQoL over time is unknown.

Objectives: To investigate the association between polypharmacy status and trajectories of HRQoL in older adults.

Methods: A longitudinal cohort study of 2181 community-dwelling adults, 65 years and older, who participated in the 2013 to 2017 waves of the Household Income and Labour Dynamics in Australia (HILDA) Survey. Polypharmacy was defined as the regular use of ≥5 prescription medications. Polypharmacy status was categorized into no polypharmacy, in 2013 only (baseline only polypharmacy), in 2017 only (incident polypharmacy) or at both time points (persistent polypharmacy). HRQoL was assessed through the SF-36 questionnaire generating two summary scores: physical component summary (PCS) and mental component summary (MCS). Linear mixed-effects models stratified according to polypharmacy status and change in comorbidities were used to assess trajectories of HRQoL.

Results: Older adults with persistent polypharmacy had lowest scores for HRQoL measures in 2013 and 2017. After adjusting for all covariates, those with incident polypharmacy had the steepest annual decline in both the PCS and MCS: -0.86 in PCS and -0.76 in MCS for those with decreasing or stable comorbidities, and -1.20 in PCS and -0.75 in MCS for those with increasing comorbidities. Over the 4-year study period, this equated to a decline of -3.44 in PCS and -3.04 in MCS for those with incident polypharmacy with decreasing or stable comorbidities, and -4.8 in PCS and -3.0 in MCS for those with incident polypharmacy with increasing comorbidities.

Conclusions: Polypharmacy was associated with poorer HRQoL, even after adjusting for confounders. Incident polypharmacy was found to be associated with a clinically important decline in HRQoL and this should be considered when prescribing additional medication to older adults.