Patient perception of health status in the setting of multimorbidity and polypharmacy: a preliminary analysis of baseline SPPiRE trial data

Abstract Introduction: Polypharmacy and multimorbidity are becoming increasingly common in an ageing population. Older people also exhibit greater utilisation of health services. Minimising adverse drug reactions and drug-drug interactions is becoming increasingly important; however, de-prescribing efforts often neglect to incorporate patient preferences.

Methods: A total of 355 patients over the age of 65, who were prescribed more than 15 medications, filled out a self-reported questionnaire that included multiple health-related quality of life scales and demographics. Prescription data was obtained from the patients’ general practice, and potentially inappropriate prescriptions (PIPs) were identified by a pharmacist. Univariate and multivariate regression analysis was carried out using the EuroQoL Visual Analogue Scale (EQ-VAS) as the outcome variable. 

Results: There was limited evidence for a relationship between patient characteristics (age, gender, education, number of medications, PIPs) and EQ-VAS score. Univariate analysis showed significant changes in EQ-VAS score corresponding with changes in various health-related quality of life subscale scores, particularly daily activities and pain.

Discussion: Both pain and the ability to carry out daily activities have a large impact on patients’ global perception of their health. This study found no evidence to suggest that, in the setting of polypharmacy and multimorbidity, the number of medications or number of PIPs affects patients’ perception of their own health.