Associations between treatment burden, socio-demographics, clinical factors and use of medicines in adults with polypharmacy: A cross-sectional study.

Abstract

Background: Understanding relationships between polypharmacy, treatment burden and other factors (e.g. age, knowledge of medicines), could inform interventions to reduce treatment burden.

Aim: To explore sociodemographic, clinical and medication factors associated with high treatment burden.

Design and setting: Secondary analysis of multi-centre UK primary care baseline clinical trial data.

Methods: Participants were ≥18 years, prescribed ≥5 repeat medicines with ≥1 indicator of potentially inappropriate prescribing (PIP). Survey data captured treatment burden (13-item Multimorbidity Treatment Burden Questionnaire; dichotomised with high burden ≥22), sociodemographic characteristics, quality of life, self-reported knowledge of medicines, and medication adherence. Electronic health records provided data on age, gender, long-term conditions, PIP, medicines use (last 3 months), and consultations (last 12 months). Associations between treatment burden and other factors were modelled using multivariable logistic regression.

Results: 1711 adults from 37 general practices were included (mean age 72 years, 51% male). 381 (23%) reported high treatment burden. Multivariable analysis found high treatment burden was associated with younger age, being unemployed or in paid work, university or high education, multimorbidity, anxiety/depression, polypharmacy (≥8 medicines), lower medication adherence, knowledge of medicines, and quality of life. There was strong evidence (p<0.005) that the association between high treatment burden and polypharmacy was greater in people aged <60 years, those with poor knowledge of medicines, more multimorbidity, and those with low/moderate medication adherence.

Conclusion: High treatment burden was more common in adults with polypharmacy who were younger, had multimorbidity, poor medication knowledge, or low adherence. This should inform design of interventions addressing treatment burden.