MEDICATION RELATED QUALITY OF LIFE (MRQOL) IN AMBULATORY OLDER ADULTS WITH POLYPHARMACY AND MULTI-MORBIDITY – A MEASURABLE OUTCOME?

Abstract Ref: 
0092

Emma Jennings1,2  Katrine Jorgensen3,4, Natasha Lewis1, Stephen Byrne3, Paul Gallagher1,2 ,
Denis O’Mahony1,2

1Department of Geriatric Medicine, Cork University Hospital, Cork, Ireland
2Department of Medicine,University College Cork National University of Ireland, Cork, Ireland
3School of Pharmacy,University College Cork National University of Ireland, Cork, Ireland
4Department of Pharmacy, Faculty of Health and Medical Sciences,University of Copenhagen,
Copenhagen,Denmark

Background: With increasing numbers of older multi-morbid people being exposed to
polypharmacy, research needs to focus on medication-related outcomes affecting qualityof-
life (QoL). This study examines older-patients’ medication-related QoL (MRQoL), its
relationship to medication burden/complexity, frailty, health-related QoL (HRQoL) and
potentially inappropriate medications (PIMs).

Methods: A cross-sectional-study was conducted in older-patients attending out-patients
and day-hospital services of a tertiary-teaching-hospital. Participants were aged ≥65
years, first-time attendees, taking ≥5 chronic-medications for ≥3 chronic-conditions and
mini-mental state examination score ≥26/30. Demographic, medication, comorbidity,
frailty status, PIMs(STOPP/STARTv.2 criteria), MRQoL (MRQoL-LS v1.0) HRQoL
(Short-form-12; SF-12) and medication burden (Living withMedicines Questionnaire v.2;
LMQv2) data were collected. Drg compliance was measured using the Medication Adherence
Rating Scale (MARS). Lower MRQoL-LS v1.0 scores indicate better MRQoL (range
0-84). Higher LMQv2 scores indicate higher medication burden (range from 60-300). A
negative age-specific mean-difference score in SF-12 physical and mental health composite scale
scores (SF12-PCS, SF12-MCS) indicates poorer health.

Results: Over 12 months, 234 patients (attending 78 clinics) were screened, 59 met
inclusion criteria and 30 were recruited; 3 patients were subsequently identified as ineligible.
Eighteen patients were female (66%), mean age was 79.4 years (SD±6.2), median number
of daily medications was 10 (IQR 8-13), median number of comorbidities was 11 (IQR
9-14).
Participants were generally drug-compliant, median MARS score of 9 (IQR 6.5-10).
Patients’ median MRQoL score was 14 (IQR 14-22.5); mean LMQ v2 score was 115.64
(SD± 25.18). Mean age specific mean-difference SF12-PCS and SF12-MCS scores were
-22.61 (SD±11.7) and -22.1 (SD±17.5) respectively.There was no significant correlation
between MRQoL and number of daily medications, number of comorbidities, LMQ,
HRQoL, or PIMs(Pearson’s 2-tailed test).

Conclusion: This study demonstrates thatMRQoL-LS v.1 is not applicable to most patients
attending geriatric ambulatory services. Furthermore, polypharmacy, multimorbidity, presence
of PIMs poorer HRQoL do not correlate significantly with MRQoL.