Medication-related quality of life (MRQoL) in ambulatory older adults with multi-morbidity and polypharmacy

Key summary pointsAim This study assesses medication-related quality-of-life using MRQoL-LS version 1 in ambulatory older adults with multi-morbidity and polypharmacy and explores potential correlations with medications, frailty and overall health-related QoL. Findings Our sample of an ambulatory older patient cohort attending a specialist hospital-based Geriatric Medicine outpatient clinic experienced baseline polypharmacy, multi-morbidity and reported poor age adjusted health-related quality of life (HRQoL). However, there was no significant relationship between MRQoL-LS version 1 scores and number of chronic comorbid conditions, number of daily medications, number of potentially inappropriate medications taken daily or measured health-related QoL. Message MRQoL-LS version 1 is not practical for most patients attending geriatric ambulatory services given the high proportion of patients attending with cognitive impairment. There is a need for a new medication-related QoL assessment tool that specifically addresses the impact of polypharmacy on QoL in multimorbid older people. Purpose To assess medication-related quality-of-life (MRQoL) in multi-morbid older adults with polypharmacy and correlations with medications, frailty and health-related QoL. Methods With a cross sectional study of multi-morbid geriatric medicine outpatients, we assessed MRQoL (MRQol-LSv1), frailty status, potentially inappropriate medications, Medication Adherence Rating Scale (MARS), health-related-QoL (Short-Form 12, SF12) and medication burden (Living with Medicines Questionnaire, LMQv2). Results One-in-four (n = 59) of 234 outpatient attendees met inclusion criteria. Almost half (n = 106, 45%) were excluded due to cognition (MMSE < 26). Included participants (n = 27, mean age 80.2 years) experienced a median of 11 (IQR 9-13.5) co-morbidities and were prescribed a median of 10 (IQR 8-12.25) medications. Overall, MRQoL-LS.v.1 scores were low, suggesting good medication-related quality of life (median MRQoL-LS.v.1 score of 14, IQR 14-22). Correlations between MRQoL, number of daily medications, co-morbidity burden, LMQv2 score, SF12 scores and number of PIMs were non-significant. Conclusion MRQoL-LSv.1 is unsuitable for most patients attending geriatric ambulatory services.

Automated summary

The study assessed medication-related quality-of-life in ambulatory older adults with multi-morbidity and polypharmacy, finding no significant relationship between MRQoL-LS version 1 scores and number of chronic comorbid conditions, number of daily medications, number of potentially inappropriate medications taken daily or measured health-related QoL. The researchers concluded that MRQoL-LS version 1 is not suitable for most patients attending geriatric ambulatory services, highlighting the need for a new medication-related QoL assessment tool specifically targeting the impact of polypharmacy on QoL in multimorbid older people.