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Drugs - Real World Outcomes
Published in: Drugs - Real World Outcomes 4/2017

Open Access 01-12-2017 | Original Research Article

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

Authors: Kenya Ie, Eric Chou, Richard D. Boyce, Steven M. Albert

Published in: Drugs - Real World Outcomes | Issue 4/2017

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Abstract

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.
Appendix
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Metadata
Title
Potentially Harmful Medication Use and Decline in Health-Related Quality of Life among Community-Dwelling Older Adults
Authors
Kenya Ie
Eric Chou
Richard D. Boyce
Steven M. Albert
Publication date
01-12-2017
Publisher
Springer International Publishing
Published in
Drugs - Real World Outcomes / Issue 4/2017
Print ISSN: 2199-1154
Electronic ISSN: 2198-9788
DOI
https://doi.org/10.1007/s40801-017-0123-8

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