Polypharmacy and Health-Related Quality of Life/Psychological Distress Among Patients With Chronic Disease

Introduction To date, no study has investigated the impact of polypharmacy (use of >= 5 medications concurrently) on health-related quality of life (HRQOL) and psychological distress in a combined sample of chronic disease patients and patients with multimorbidity, using diverse HRQOL measures. This study aimed to explore the associ-ation between polypharmacy and HRQOL/psychological distress by using data from a cross-sectional study in Flanders (Belgium).Methods We analyzed cross-sectional survey data on 544 chronically ill pa-tients recruited from June 2019 through June 2021. HRQOL was measured with the EuroQol-5 Dimension-5 Level questionnaire (EQ-5D-5L) and the 12-Item Short Form Health Survey (SF-12); psychological distress was measured with the Hospital Anxiety and Depression Scale (HADS). Multiple linear regression models were built to assess the association between polypharmacy and HRQOL/psychological distress.Results Overall, compared with patients without polypharmacy, patients with polypharmacy reported worse EQ-5D-5L index values, EuroQol visual analogue scale (EQ-VAS) scores, SF-12 physical component scores (PCS), SF-12 mental component scores (MCS), and HADS anxiety and depression subscales. In the final regres-sion model adjusting for age, sex, educational attainment, and multimorbidity, polypharmacy remained significantly associated with lower HRQOL in terms of the EQ-5D-5L index (f3 = -0.12; P = .008), EQ-VAS (f3 = -0.11; P = .01), and SF-12 PCS (f3 = -0.15; P = .002) but not with psychological distress (HADS) and SF-12 MCS.Conclusion This study found that polypharmacy was negatively associated with the physical domain of HRQOL, but not with the mental do-main, among patients with chronic diseases. These results may be especially important for patients with multimorbidity, given their greater risk of polypharmacy.