Association between potentially inappropriate medications prescription and health-related quality of life among US older adults

Collin M Clark; Jiajie Guan; Aman R Patel; Jennifer Stoll; Robert G Wahler Jr; Steven Feuerstein; Ranjit Singh; David M Jacobs

doi:10.1111/jgs.18957

Association between potentially inappropriate medications prescription and health-related quality of life among US older adults

J Am Geriatr Soc. 2024 May 10. doi: 10.1111/jgs.18957. Online ahead of print.

Authors

Collin M Clark¹, Jiajie Guan², Aman R Patel¹, Jennifer Stoll³, Robert G Wahler Jr¹, Steven Feuerstein¹, Ranjit Singh³, David M Jacobs¹

Affiliations

¹ Department of Pharmacy Practice, University at Buffalo School of Pharmacy and Pharmaceutical Sciences, Buffalo, New York, USA.
² Department of Pharmacy, State University of New York Upstate Medical University, Syracuse, New York, USA.
³ Department of Family Medicine, Primary Care Research Institute, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, New York, USA.

PMID: 38725422
DOI: 10.1111/jgs.18957

Abstract

Background: Potentially inappropriate medications (PIMs) are associated with worse health outcomes among older adults. Our objective was to examine the association between PIM prescription and health-related quality of life (HRQoL) among older adults in the United States using nationally representative data.

Methods: This was a retrospective study utilizing 2011-2015 Medical Expenditure Panel Survey (MEPS) data. Community dwelling US adults aged 65 years or older were included. A qualified definition operationalized from the 2019 American Geriatrics Society Beers Criteria® was used to define exposure to PIMs during the study period. The Physical Component Summary (PCS) and Mental Component Summary (MCS) of the Medical Outcomes Study 12-Item Short Form Health Survey (SF-12) were used to measure HRQoL. Survey-weighted linear regression models were constructed to investigate the association between PIM exposure and participants' PCS and MCS scores. Analyses were stratified across three age cohorts (65-74, 75-85, and ≥85 years).

Results: Unadjusted analysis showed poorer scores in the PIM exposed group for both PCS and MCS (all p < 0.001). PIM exposure was associated with poorer PCS scores across all age groups with those aged 65-74 years (adjusted regression coefficient = -1.60 [95% CI = -2.27, -0.93; p < 0.001]), those 75-84 years (adjusted regression coefficient: -1.49 [95% CI = -2.45, -0.53; p = 0.003]), and those 85 years and older (adjusted regression coefficient = -1.65 [95% CI = -3.03, -0.27; p = 0.02]). PIM exposure was also associated with poorer MCS scores in participants aged 65-74 years (adjusted regression coefficient = -0.69 [95% CI = -1.16, -0.22; p = 0.004]) and 85 years and older (adjusted regression coefficient = -2.01 [95% CI = -3.25, -0.78; p = 0.002]).

Conclusions: Our results suggest that patients' exposure to PIMs is associated with poorer HRQoL. Further work is needed to assess whether interventions to deprescribe PIMs may help to improve patients' HRQoL.

Keywords: health‐related quality of life; older adults; potentially inappropriate medications.

Abstract

Grants and funding