Quality of prescribing and health-related quality of life in older adults: a narrative review with a special focus on patients with atrial fibrillation and multimorbidity.
Cheima Amrouch, Deirdre A Lane, Amaia Calderón-Larrañaga, Mirko Petrovic, Delphine De Smedt
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引用次数: 0
Abstract
Purpose: To summarise the association between potentially inappropriate prescribing (PIP) and health-related quality of life (HRQOL) in older adults, with a special focus on those with atrial fibrillation (AF) and multimorbidity, while exploring potential interventions to improve prescribing quality and their impact on HRQOL.
Methods: A comprehensive search strategy was conducted in MEDLINE using the PubMed interface on August 16th, 2024, focusing on key terms related to "potentially inappropriate prescribing" and "quality of life". Additionally, the reference lists of included studies were screened. Only studies utilising validated assessment tools for HRQOL or measuring global self-perceived health status were considered. Studies involving populations with an average age of ≥ 65 years were included.
Results: Of the 1810 articles screened, 35 studies were included. The findings indicate that the quality of prescribing, independent of polypharmacy, may negatively influence HRQOL. The review identified a range of interventions aimed at improving prescribing quality among older adults, including pharmacist-driven, general practitioner-driven, and multidisciplinary approaches. Interventions were assessed among distinct population groups and specifically in residential care homes. While some interventions demonstrated improvements in prescribing quality, the overall evidence regarding their impact on HRQOL remains limited.
Conclusion: The relationship between prescribing quality and HRQOL remains underexplored in older adults with AF and multimorbidity, despite the high prevalence of PIP. Effective pharmacotherapy should be coupled with a comprehensive assessment of patients' clinical and functional parameters, considering their HRQOL. Adopting a multidisciplinary, integrated, patient-centred approach is essential for sustainable and appropriate prescribing practices and may enhance HRQOL.
期刊介绍：
European Geriatric Medicine is the official journal of the European Geriatric Medicine Society (EUGMS). Launched in 2010, this journal aims to publish the highest quality material, both scientific and clinical, on all aspects of Geriatric Medicine.
The EUGMS is interested in the promotion of Geriatric Medicine in any setting (acute or subacute care, rehabilitation, nursing homes, primary care, fall clinics, ambulatory assessment, dementia clinics..), and also in functionality in old age, comprehensive geriatric assessment, geriatric syndromes, geriatric education, old age psychiatry, models of geriatric care in health services, and quality assurance.
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