title: Polypharmacy and medication regimen complexity as factors associated with staff informant rated quality of life in residents of aged care facilities: a cross-sectional study.
abstract: OBJECTIVE
  The purpose of this study is to investigate the association between polypharmacy with health-related quality of life (HRQoL) and medication regimen complexity with HRQoL in residential aged care facilities (RACFs).
  
  
  METHODS
  A cross-sectional study of 383 residents from six Australian RACFs was conducted. The primary exposures were polypharmacy (≥9 regular medications) and the validated Medication Regimen Complexity Index (MRCI). The outcome measure was staff informant rated quality of life assessed using the Quality of Life Alzheimer's disease (QoL-AD) scale. Covariates included age, sex, Charlson's comorbidity index, activities of daily living, and dementia severity. Logistic quantile regression was used to characterize the association between polypharmacy and QoL-AD (model 1) and MRCI and QoL-AD (model 2).
  
  
  RESULTS
  The median age of the 383 residents was 88 years and 297 (78 %) residents were female. In total, 63 % of residents were exposed to polypharmacy and the median MRCI score (range) was 43.5 (4-113). After adjusting for the covariates, polypharmacy was not associated with either higher or lower QoL-AD scores (estimate -0.02; 95 % confidence interval (CI) -0.165, 0.124; p = 0.78). Similarly, after adjusting for the covariates, MRCI was not associated with either higher or lower QoL-AD scores (estimate -0.0009, 95 % CI -0.005, 0.003; p = 0.63).
  
  
  CONCLUSIONS
  These findings suggest that polypharmacy and medication regimen complexity are not associated with staff informant rated HRQoL. Further research is needed to investigate how specific medication classes may impact change in quality of life over time.
authors.affiliation: Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Melbourne, Australia. Samanta.Lalic@monash.edu.|Pharmacy Department, Austin Health, Melbourne, Melbourne, Australia. Samanta.Lalic@monash.edu.
authors.forename: Samanta
authors.initials: S
authors.lastname: Lalic
authors.affiliation: Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Melbourne, Australia.
authors.forename: Kris M
authors.initials: KM
authors.lastname: Jamsen
authors.affiliation: Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Melbourne, Australia.
authors.forename: Barbara C
authors.initials: BC
authors.lastname: Wimmer
authors.affiliation: Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Melbourne, Australia.
authors.forename: Edwin C K
authors.initials: EC
authors.lastname: Tan
authors.affiliation: NHMRC Cognitive Decline Partnership Centre, Hornsby Ku-ring-gai Hospital, Hornsby, NSW, Australia.|Departments of Clinical Pharmacology and Aged Care, Kolling Institute of Medical Research, Sydney Medical School, Royal North Shore Hospital, The University of Sydney, Sydney, Australia.
authors.forename: Sarah N
authors.initials: SN
authors.lastname: Hilmer
authors.affiliation: Resthaven Incorporated, Adelaide, Australia.
authors.forename: Leonie
authors.initials: L
authors.lastname: Robson
authors.affiliation: Resthaven Incorporated, Adelaide, Australia.
authors.forename: Tina
authors.initials: T
authors.lastname: Emery
authors.affiliation: Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Melbourne, Australia.|NHMRC Cognitive Decline Partnership Centre, Hornsby Ku-ring-gai Hospital, Hornsby, NSW, Australia.|Sansom Institute, School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, Australia.
authors.forename: J Simon
authors.initials: JS
authors.lastname: Bell
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001315:Australia; D003430:Cross-Sectional Studies; D004363:Drug Utilization; D005260:Female; D006707:Homes for the Aged / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D019338:Polypharmacy; D011788:Quality of Life
keywords: Medication regimen complexity; Nursing homes; Polypharmacy; Quality of life; Residential aged care