Polypharmacy is often a finding at the end of life. A recent study of adults with advanced, life-limiting illness examined the possible effects of this syndrome upon symptom burden (assessed using the Edmonton Symptom Assessment Scale) and quality of life (assessed using the McGill QOL Questionnaire). The mean symptom score for all 372 subjects was 27.0 (standard deviation (SD) 16.1) and the mean QOL score was 7.0 (SD 1.3). The average number of non-statin medications was 11.6 (SD 5.0); one-third of participants took ≥ 14 medications. More polypharmacy was associated with higher symptom burden and lower QOL and an adjustment for symptom burden weakened the association between polypharmacy and QOL (coefficient − .03; p = .045) without a significant interaction, suggesting that worse quality of life associated with polypharmacy may be related to medication-associated symptoms. This study tends to confirm that more attention to deprescribing is needed at the end of life… Read more here
Conclusions
Among adults with advanced illness, taking more medications is associated with higher symptom burden and lower QOL. Attention to medication-related symptoms and shared decision-making regarding deprescribing are warranted in this setting.