The effect of polypharmacy on quality of life in adult patients with nonalcoholic fatty liver disease in the United States.
Liver disease
NAFLD
NASH
Nonalcoholic fatty liver disease
Polypharmacy
Quality of life
Journal
Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation
ISSN: 1573-2649
Titre abrégé: Qual Life Res
Pays: Netherlands
ID NLM: 9210257
Informations de publication
Date de publication:
Aug 2022
Aug 2022
Historique:
accepted:
11
01
2022
pubmed:
23
1
2022
medline:
7
7
2022
entrez:
22
1
2022
Statut:
ppublish
Résumé
Nonalcoholic fatty liver disease (NAFLD) is a significant epidemiological problem with rising prevalence. Due to limited literature, the objective of this study is to examine the association between polypharmacy and health-related quality of life (QoL) in NAFLD adult patients. A retrospective observational study design was conducted to analyze health data collected by Steatohepatitis Clinical Research Network (NASH CRN). Patients were classified as receiving a polypharmacy therapy with five or more medications in their first screening visit. QoL was measured using the Short Form 36 (SF-36) instrument. Each patient self-reported the SF-36 form during the screening visit was compared between polypharmacy and non-polypharmacy groups using Wilcoxon Rank Sum test. Multivariable generalized linear models and multinomial logistic regression were performed to examine each predictor and its effect on QoL. Data included 1067 NAFLD adult patients; 834 patients used polypharmacy. The mean age was 48.64 years, and most patients were female (62%). Comparing NAFLD patients without steatohepatitis, borderline NASH, and definite NASH, the non-polypharmacy group had a significantly higher QoL than the polypharmacy group in Physical Component Summary (PCS) (86.25 vs 66.88, 85 vs 67.5, and 79.375 vs 63.12, respectively, all p < 0.01) and Mental Component Summary (MCS) (83.5 vs 73.38, 78.75 vs 67.62, and 78.75 vs 70.65, respectively, all p < 0.01). Adults with NAFLD and polypharmacy have lower QoL than adults with NAFLD and non-polypharmacy. Number of medications had a significant negative impact on PCS, MCS, and all SF-36 domains except mental health, role physical limitation and role emotional limitation domains. Other factors that affect QoL negatively in NAFLD adult patients are female gender, obesity, diabetes, depression, and unemployment. Higher income had favorable effect on QoL.
Sections du résumé
BACKGROUND
BACKGROUND
Nonalcoholic fatty liver disease (NAFLD) is a significant epidemiological problem with rising prevalence. Due to limited literature, the objective of this study is to examine the association between polypharmacy and health-related quality of life (QoL) in NAFLD adult patients.
METHODS
METHODS
A retrospective observational study design was conducted to analyze health data collected by Steatohepatitis Clinical Research Network (NASH CRN). Patients were classified as receiving a polypharmacy therapy with five or more medications in their first screening visit. QoL was measured using the Short Form 36 (SF-36) instrument. Each patient self-reported the SF-36 form during the screening visit was compared between polypharmacy and non-polypharmacy groups using Wilcoxon Rank Sum test. Multivariable generalized linear models and multinomial logistic regression were performed to examine each predictor and its effect on QoL.
RESULTS
RESULTS
Data included 1067 NAFLD adult patients; 834 patients used polypharmacy. The mean age was 48.64 years, and most patients were female (62%). Comparing NAFLD patients without steatohepatitis, borderline NASH, and definite NASH, the non-polypharmacy group had a significantly higher QoL than the polypharmacy group in Physical Component Summary (PCS) (86.25 vs 66.88, 85 vs 67.5, and 79.375 vs 63.12, respectively, all p < 0.01) and Mental Component Summary (MCS) (83.5 vs 73.38, 78.75 vs 67.62, and 78.75 vs 70.65, respectively, all p < 0.01).
DISCUSSION AND CONCLUSION
CONCLUSIONS
Adults with NAFLD and polypharmacy have lower QoL than adults with NAFLD and non-polypharmacy. Number of medications had a significant negative impact on PCS, MCS, and all SF-36 domains except mental health, role physical limitation and role emotional limitation domains. Other factors that affect QoL negatively in NAFLD adult patients are female gender, obesity, diabetes, depression, and unemployment. Higher income had favorable effect on QoL.
Identifiants
pubmed: 35064417
doi: 10.1007/s11136-022-03090-6
pii: 10.1007/s11136-022-03090-6
doi:
Types de publication
Journal Article
Observational Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
2481-2491Informations de copyright
© 2022. The Author(s), under exclusive licence to Springer Nature Switzerland AG.
Références
Ludwig, J., Viggiano, T. R., McGill, D. B., & Oh, B. J. (1980). Nonalcoholic steatohepatitis: Mayo Clinic experiences with a hitherto unnamed disease. Mayo Clinic Proceedings, 55(7), 434–438.
pubmed: 7382552
Definition & Facts of NAFLD & NASH | NIDDK [Internet]. National Institute of Diabetes and Digestive and Kidney Diseases. Retrieved January 29, 2021, from https://www.niddk.nih.gov/health-information/liver-disease/nafld-nash/definition-facts
Chalasani, N., Younossi, Z., Lavine, J. E., Charlton, M., Cusi, K., Rinella, M., et al. (2018). The diagnosis and management of nonalcoholic fatty liver disease: Practice guidance from the American Association for the Study of Liver Diseases. Hepatology, 67(1), 328–357.
pubmed: 28714183
doi: 10.1002/hep.29367
Cholankeril, G., Wong, R. J., Hu, M., Perumpail, R. B., Yoo, E. R., Puri, P., et al. (2017). Liver Transplantation for nonalcoholic steatohepatitis in the US: Temporal trends and outcomes. Digestive Diseases and Sciences, 62(10), 2915–2922.
pubmed: 28744836
doi: 10.1007/s10620-017-4684-x
Wong, R. J., Aguilar, M., Cheung, R., Perumpail, R. B., Harrison, S. A., Younossi, Z. M., et al. (2015). Nonalcoholic steatohepatitis is the second leading etiology of liver disease among adults awaiting liver transplantation in the United States. Gastroenterology, 148(3), 547–555.
pubmed: 25461851
doi: 10.1053/j.gastro.2014.11.039
Younossi, Z. M., Stepanova, M., Younossi, Y., Golabi, P., Mishra, A., Rafiq, N., et al. (2020). Epidemiology of chronic liver diseases in the USA in the past three decades. Gut, 69(3), 564–568.
pubmed: 31366455
doi: 10.1136/gutjnl-2019-318813
Vernon, G., Baranova, A., & Younossi, Z. M. (2011). Systematic review: The epidemiology and natural history of non-alcoholic fatty liver disease and non-alcoholic steatohepatitis in adults. Alimentary Pharmacology & Therapeutics, 34(3), 274–285.
doi: 10.1111/j.1365-2036.2011.04724.x
Williams, C. D., Stengel, J., Asike, M. I., Torres, D. M., Shaw, J., Contreras, M., et al. (2011). Prevalence of nonalcoholic fatty liver disease and nonalcoholic steatohepatitis among a largely middle-aged population utilizing ultrasound and liver biopsy: A prospective study. Gastroenterology, 140(1), 124–131.
pubmed: 20858492
doi: 10.1053/j.gastro.2010.09.038
Bang, K. B., & Cho, Y. K. (2015). Comorbidities and metabolic derangement of NAFLD. Journal of Lifestyle Medicine, 5(1), 7–13.
pubmed: 26528424
pmcid: 4608226
doi: 10.15280/jlm.2015.5.1.7
Adams, L. A., Lymp, J. F., St. Sauver, J., Sanderson, S. O., Lindor, K. D., Feldstein, A., et al. (2005). The natural history of nonalcoholic fatty liver disease: A population-based cohort study. Gastroenterology, 129(1), 113–121.
pubmed: 16012941
doi: 10.1053/j.gastro.2005.04.014
Younossi, Z., & Henry, L. (2016). Contribution of alcoholic and nonalcoholic fatty liver disease to the burden of liver-related morbidity and mortality. Gastroenterology, 150(8), 1778–1785.
pubmed: 26980624
doi: 10.1053/j.gastro.2016.03.005
Mohamad, B., Shah, V., Onyshchenko, M., Elshamy, M., Aucejo, F., Lopez, R., et al. (2016). Characterization of hepatocellular carcinoma (HCC) in non-alcoholic fatty liver disease (NAFLD) patients without cirrhosis. Hepatology International, 10(4), 632–639.
pubmed: 26558795
doi: 10.1007/s12072-015-9679-0
Masnoon, N., Shakib, S., Kalisch-Ellett, L., & Caughey, G. E. (2017). What is polypharmacy? A systematic review of definitions. BMC Geriatrics, 17(1), 230.
pubmed: 29017448
pmcid: 5635569
doi: 10.1186/s12877-017-0621-2
Bakaki, P. M., Horace, A., Dawson, N., Winterstein, A., Waldron, J., Staley, J., et al. (2018). Defining pediatric polypharmacy: A scoping review. PLoS ONE, 13(11), e0208047.
pubmed: 30496322
pmcid: 6264483
doi: 10.1371/journal.pone.0208047
Gu, Q., Dillon, C. F., & Burt, V. L. (2010). Prescription drug use continues to increase: U.S. Prescription Drug Data for 2007–2008: (665492010–001). American Psychological Association. https://doi.org/10.1037/e665492010-001
doi: 10.1037/e665492010-001
Kantor, E. D., Rehm, C. D., Haas, J. S., Chan, A. T., & Giovannucci, E. L. (2015). Trends in prescription drug use among adults in the United States From 1999–2012. JAMA, 314(17), 1818.
pubmed: 26529160
pmcid: 4752169
doi: 10.1001/jama.2015.13766
HRQOL Concepts | CDC [Internet]. (2018). Retrieved February 9, 2021, from https://www.cdc.gov/hrqol/concept.htm
Monica 1776 Main Street Santa, California 90401–3208. 36-Item Short Form Survey from the RAND Medical Outcomes Study [Internet]. Retrieved February 1, 2021, from https://www.rand.org/health-care/surveys_tools/mos/36-item-short-form.html
Ware, J. E., & Gandek, B. (1998). Overview of the SF-36 Health Survey and the International Quality of Life Assessment (IQOLA) Project. Journal of Clinical Epidemiology, 51(11), 903–912.
pubmed: 9817107
doi: 10.1016/S0895-4356(98)00081-X
Dan, A. A., Kallman, J. B., Wheeler, A., Younoszai, Z., Collantes, R., Bondini, S., et al. (2007). Health-related quality of life in patients with non-alcoholic fatty liver disease. Alimentary Pharmacology & Therapeutics, 26(6), 815–820.
doi: 10.1111/j.1365-2036.2007.03426.x
Assimakopoulos, K., Karaivazoglou, K., Tsermpini, E.-E., Diamantopoulou, G., & Triantos, C. (2018). Quality of life in patients with nonalcoholic fatty liver disease: A systematic review. Journal of Psychosomatic Research, 112, 73–80.
pubmed: 30097139
doi: 10.1016/j.jpsychores.2018.07.004
Sayiner, M., Stepanova, M., Pham, H., Noor, B., Walters, M., & Younossi, Z. M. (2016). Assessment of health utilities and quality of life in patients with non-alcoholic fatty liver disease. BMJ Open Gastroenteroligy, 3(1), e000106.
doi: 10.1136/bmjgast-2016-000106
Chawla, K. S., Talwalkar, J. A., Keach, J. C., Malinchoc, M., Lindor, K. D., & Jorgensen, R. (2016). Reliability and validity of the Chronic Liver Disease Questionnaire (CLDQ) in adults with non-alcoholic steatohepatitis (NASH). BMJ Open Gastroenterology, 3(1), e000069.
pubmed: 27110379
pmcid: 4838661
doi: 10.1136/bmjgast-2015-000069
Patel, P. J., Hayward, K. L., Rudra, R., Horsfall, L. U., Hossain, F., Williams, S., et al. (2017). Multimorbidity and polypharmacy in diabetic patients with NAFLD. Medicine (Baltimore), 96, e6761.
doi: 10.1097/MD.0000000000006761
Spengler, E. K., & Loomba, R. (2015). Recommendations for diagnosis, referral for liver biopsy, and treatment of NAFLD and NASH. Mayo Clinic Proceedings, 90(9), 1233–1246.
pubmed: 26219858
doi: 10.1016/j.mayocp.2015.06.013
Babcock, Z. R., Kogut, S. J., & Vyas, A. (2020). Association between polypharmacy and health-related quality of life among cancer survivors in the United States. Journal of Cancer Survivorship, 14(1), 89–99.
pubmed: 31792811
doi: 10.1007/s11764-019-00837-y
Schenker, Y., Park, S. Y., Jeong, K., Pruskowski, J., Kavalieratos, D., Resick, J., et al. (2019). Associations between polypharmacy, symptom burden, and quality of life in patients with advanced, life-limiting illness. Journal of General Internal Medicine, 34(4), 559–566.
pubmed: 30719645
pmcid: 6445911
doi: 10.1007/s11606-019-04837-7
Okoli, C., de los Rios, P., Eremin, A., Brough, G., Young, B., & Short, D. (2020). Relationship between polypharmacy and quality of life among people in 24 Countries living with HIV. Preventing Chronic Disease, 17, 190359.
doi: 10.5888/pcd17.190359
(2003). Nonalcoholic steatohepatitis clinical research network. Hepatology 37(2):244
Monica 1776 Main Street Santa, California 90401–3208. 36-Item Short Form Survey (SF-36) Scoring Instructions [Internet]. Retrieved September 6, 2021, from https://www.rand.org/health-care/surveys_tools/mos/36-item-short-form/scoring.html
Standard_Operating_Procedures.pdf [Internet]. Retrieved December 13, 2021 from https://repository.niddk.nih.gov/media/studies/nafld_adult/Standard_Operating_Procedures.pdf
Woźniak, I., Kolonko, A., Chudek, J., Nowak, Ł, Farnik, M., & Więcek, A. (2018). Influence of polypharmacy on the quality of life in stable kidney transplant recipients. Transplantation Proceedings, 50(6), 1896–1899.
pubmed: 30056924
doi: 10.1016/j.transproceed.2018.02.128
Alexander, H. B., Broshek, D. K., & Quigg, M. (2018). Quality of life in adults with epilepsy is associated with anticonvulsant polypharmacy independent of seizure status. Epilepsy & Behavior, 78, 96–99.
doi: 10.1016/j.yebeh.2017.11.006
Vyas, A., Kang, F., & Barbour, M. (2020). Association between polypharmacy and health-related quality of life among US adults with cardiometabolic risk factors. Quality of Life Research, 29(4), 977–986.
pubmed: 31786690
doi: 10.1007/s11136-019-02377-5
Golabi, P., Otgonsuren, M., Cable, R., Felix, S., Koenig, A., Sayiner, M., et al. (2016). Non-alcoholic fatty liver disease (NAFLD) is associated with impairment of Health Related Quality of Life (HRQOL). Health and Quality of Life Outcomes, 14, 18.
pubmed: 26860700
pmcid: 4746896
doi: 10.1186/s12955-016-0420-z
Kennedy-Martin, T., Bae, J. P., Paczkowski, R., & Freeman, E. (2017). Health-related quality of life burden of nonalcoholic steatohepatitis: A robust pragmatic literature review. Journal of Patient-Reported Outcomes, 2, 28.
pubmed: 29984351
doi: 10.1186/s41687-018-0052-7
Bezemer, G., Van Gool, A. R., Verheij-Hart, E., Hansen, B. E., Lurie, Y., Esteban, J. I., et al. (2012). Long-term effects of treatment and response in patients with chronic hepatitis C on quality of life. An international, multicenter, randomized, controlled study. BMC Gastroenterology, 12(1), 11.
pubmed: 22292521
pmcid: 3293759
doi: 10.1186/1471-230X-12-11
Huber, Y., Boyle, M., Hallsworth, K., Tiniakos, D., Straub, B. K., Labenz, C., et al. (2019). Health-related quality of life in nonalcoholic fatty liver disease associates with hepatic inflammation. Clinical Gastroenterology and Hepatology, 17(10), 2085-2092.e1.
pubmed: 30580090
doi: 10.1016/j.cgh.2018.12.016
David, K., Kowdley, K. V., Unalp, A., Kanwal, F., Brunt, E. M., & Schwimmer, J. B. (2009). Quality of life in adults with nonalcoholic fatty liver disease: Baseline data from the nonalcoholic steatohepatitis clinical research network. Hepatology, 49(6), 1904–1912.
pubmed: 19434741
doi: 10.1002/hep.22868
Alrasheed, M., Alsuhibani, A., Hincapie, A. L., Welge, J. (2021) Comparison of quality of life between men and women with chronic liver diseases using chronic liver disease questionnaire (CLDQ): A meta-analysis. In Pharmacoepidemiology and Drug Safety 2021 Aug 1 (Vol. 30, pp. 181–181). 111 RIVER ST, HOBOKEN 07030–5774, NJ USA: WILEY.
Younossi, Z. M., Stepanova, M., Sulkowski, M., Naggie, S., Henry, L., & Hunt, S. (2016). Sofosbuvir and ledipasvir improve patient-reported outcomes in patients co-infected with hepatitis C and human immunodeficiency virus. Journal of Viral Hepatitis, 23(11), 857–865.
pubmed: 27291391
doi: 10.1111/jvh.12554
Dulai, P. S., Singh, S., Patel, J., Soni, M., Prokop, L. J., Younossi, Z., et al. (2017). Increased risk of mortality by fibrosis stage in nonalcoholic fatty liver disease: Systematic review and meta-analysis. Hepatology (Baltimore, MD), 65(5), 1557–1565.
doi: 10.1002/hep.29085
Hagström, H., Nasr, P., Ekstedt, M., Hammar, U., Stål, P., Hultcrantz, R., et al. (2017). Fibrosis stage but not NASH predicts mortality and time to development of severe liver disease in biopsy-proven NAFLD. Journal of Hepatology, 67(6), 1265–1273.
pubmed: 28803953
doi: 10.1016/j.jhep.2017.07.027
Choi, J. M., Chung, G. E., Kang, S. J., Kwak, M.-S., Yang, J. I., Park, B., et al. (2021). Association between anxiety and depression and nonalcoholic fatty liver disease. Frontiers in Medicine, 7, 1068.
doi: 10.3389/fmed.2020.585618
Elliott, T. E., Renier, C. M., & Palcher, J. A. (2003). Chronic pain, depression, and quality of life: Correlations and predictive value of the SF-36. Chronic Pain, 4, 331.
McKee-Ryan, F., Song, Z., Wanberg, C. R., & Kinicki, A. J. (2005). Psychological and physical well-being during unemployment: A meta-analytic study. Journal of Applied Psychology, 90(1), 53.
pubmed: 15641890
doi: 10.1037/0021-9010.90.1.53
Paul, K. I., & Moser, K. (2009). Unemployment impairs mental health: Meta-analyses. Journal of Vocational Behavior, 74(3), 264–282.
doi: 10.1016/j.jvb.2009.01.001
Bartley, M. (1994). Unemployment and ill health: Understanding the relationship. Journal of Epidemiology and Community Health, 48(4), 333–337.
pubmed: 7964329
pmcid: 1059979
doi: 10.1136/jech.48.4.333
Rodriguez, E. (2001). Keeping the unemployed healthy: The effect of means-tested and entitlement benefits in Britain, Germany, and the United States. American Journal of Public Health, 91(9), 1403–1411.
pubmed: 11527771
pmcid: 1446794
doi: 10.2105/AJPH.91.9.1403
Artazcoz, L., Benach, J., Borrell, C., & Cortes, I. (2004). Unemployment and mental health: Understanding the interactions among gender, family roles, and social class. American Journal of Public Health. https://doi.org/10.2105/AJPH.94.1.82
doi: 10.2105/AJPH.94.1.82
pubmed: 14713703
pmcid: 1449831
Bunevicius, A. (2017). Reliability and validity of the SF-36 Health Survey Questionnaire in patients with brain tumors: A cross-sectional study. Health and Quality of Life Outcomes, 15, 92.
pubmed: 28472964
pmcid: 5418840
doi: 10.1186/s12955-017-0665-1
Brazier, J. E., Harper, R., Jones, N. M., O’Cathain, A., Thomas, K. J., Usherwood, T., et al. (1992). Validating the SF-36 health survey questionnaire: New outcome measure for primary care. BMJ, 305(6846), 160–164.
pubmed: 1285753
pmcid: 1883187
doi: 10.1136/bmj.305.6846.160
Failde, I., & Ramos, I. (2000). Validity and reliability of the SF-36 Health Survey Questionnaire in patients with coronary artery disease. Journal of Clinical Epidemiology, 53(4), 359–365.
pubmed: 10785566
doi: 10.1016/S0895-4356(99)00175-4
McHorney, C. A., Ware, J. E., Lu, J. F. R., & Sherbourne, C. D. (1994). The MOS 36-item short-form health survey (SF-36): III. Tests of data quality, scaling assumptions, and reliability across diverse patient groups. Medical Care, 32(1), 40–66.
pubmed: 8277801
doi: 10.1097/00005650-199401000-00004
Posthouwer, D., Plug, I., van der Bom, J. G., Fischer, K., Rosendaal, F. R., & Mauser-Bunschoten, E. P. (2005). Hepatitis C and health-related quality of life among patients with hemophilia. Haematologica, 90(6), 846–850.
pubmed: 15951299