Potentially Harmful Medication Use and Decline in Health-Related Quality of Life among Community-Dwelling Older Adults

Details

• Alternative Title:
  Drugs Real World Outcomes
• Personal Author:
  Ie, Kenya ; Chou, Eric ; Boyce, Richard D. ; Albert, Steven M.
• Description:
  Background
  
  Several scales to quantify the impact of potentially harmful medications (PHMs) have been shown to predict mortality and functional decline; however, the effect of PHMs on quality of life (QoL) has not been well-studied.
  
  Objective
  
  The aims of this study were to investigate an association between PHM use and change in health-related QoL among community-dwelling older adults, and to compare the predictive capacity of PHM scales.
  
  Methods
  
  We conducted a retrospective cohort study using prescription claims data and survey responses. A total of 426 community-dwelling adults aged 65 years or older who visited senior centers and had received prescriptions through a statewide prescription drug subsidy program were included. Anticholinergic Cognitive Burden (ACB), Drug Burden Index-sedative component (DBI-Se), Drug Burden Index-anticholinergic component (DBI-ACh), and the number of regular medications and Beers list medications were calculated from the claims data between baseline and 12 months. In addition, change in the EuroQoL five-dimensions questionnaire (EQ-5D) between baseline and 6- and 12-month follow-up were measured as the main outcome. A linear mixed model was used for the analysis.
  
  Results
  
  After adjusting for covariates, both DBI-Se (coefficients − 0.076, 95% confidence interval [CI] − 0.131 to − 0.020) and DBI-Ach (coefficients − 0.095, 95% CI − 0.188 to − 0.002) significantly predicted a decline in EQ-5D index. The ACB, number of regular medications, and number of Beers medications did not have a significant association with EQ-5D changes.
  
  Conclusions
  
  PHM measures incorporating dose revealed a better predictive capacity for QoL change. Reducing cumulative drug dose, as well as stopping medications, would be important for the well-being of this population.
  
  Electronic supplementary material
  
  The online version of this article (10.1007/s40801-017-0123-8) contains supplementary material, which is available to authorized users.
  
  
• Subjects:
  Aged Drug Interactions Drug Prescriptions Drug Utilization Home Care Services Homes For The Aged Humans Medication Errors Practice Patterns, Physicians' Prescriptions
• Source:
  Drugs Real World Outcomes. 4(4):257-264.
• Pubmed ID:
  29119486
• Pubmed Central ID:
  PMC5684052
• Document Type:
  Journal Article
• Funding:
  P30 AG024827/AG/NIA NIH HHS/United States ; R01 LM011838/LM/NLM NIH HHS/United States ; K01 AG044433/National Institute of Aging/United States ; U48 DP002657/DP/NCCDPHP CDC HHS/United States ; AG024827/National Institutes of Health/United States ; DP002657/Centers for Disease Control and Prevention/United States ; K01 AG044433/AG/NIA NIH HHS/United States
• Volume:
  4
• Issue:
  4
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:74397980e44b1e9b6be95a51cc265c8cb2d8e02b82dbc6517caf6bef83dff1ae
• Download URL:
  https://stacks.cdc.gov/view/cdc/50143/cdc_50143_DS1.pdf
• File Type:
  [PDF - 443.39 KB ]