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Association between polypharmacy, patient-reported symptoms, and quality of life among nonalcoholic fatty liver disease patients in the United States

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Abstract

Background

Nonalcoholic fatty liver disease (NAFLD) is a silent disease, yet patients might report nonspecific symptoms. The objectives of this study were to examine the effect of polypharmacy on patient-reported symptoms in NAFLD adult patients and to examine the impact of patient-reported symptoms on quality of life (QoL).

Methods

A retrospective observational study was conducted to evaluate NAFLD patient-reported symptoms, QoL, and polypharmacy in the US. QoL was measured using the 36-Item Short Form Survey (SF-36) questionnaire. Patients were classified as having polypharmacy if they used five medications or more. The comparisons of patient-reported symptoms between patients with and without polypharmacy were done using the Wilcoxon Rank Sum Test. To examine each symptom and its effect on QoL, multivariable linear models were performed on QoL scores.

Results

The study included 1032 patients. The average percentage of reporting “none at all” in patients with polypharmacy was 50%, while it was 66% in the non-polypharmacy group (p < 0.01). In multivariable linear models, the symptoms that had a negative impact on QoL in terms of physical health were muscle weakness, fatigue, and swelling of ankles (B = − 13.7, − 9.7, and − 7.914, respectively; all p < 0.01). For mental health, depression/sadness, fatigue, and muscle weakness were the most common symptoms that negatively affected QoL (B = − 20.3, − 11.2 and − 7.1, respectively; all p < 0.01)

Conclusion

NAFLD patients with polypharmacy reported more symptoms than NAFLD patients with non-polypharmacy. Fatigue and muscle weakness were the most common symptoms that negatively affected physical health QoL, while depression/sadness and fatigue had a negative impact on mental health QoL.

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Acknowledgements

The NAFLD Adult and PIVENS were conducted by the NAFLD Adult and PIVENS investigators and supported by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). The data from the NAFLD Adult and PIVENS reported here were supplied by the NIDDK Central Repositories. This manuscript was not prepared in collaboration with Investigators of the NAFLD Adult and PIVENS studies and does not necessarily reflect the opinions or views of the NAFLD Adult and PIVENS studies, the NIDDK Central Repositories, or the NIDDK.

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Authors and Affiliations

  1. James L. Winkle College of Pharmacy, University of Cincinnati, 3225 Eden Ave, Cincinnati, OH, 45267-0004, USA

    Marwan Alrasheed, Jeff Jianfei Guo, Alex C. Lin, Patricia R. Wigle & Ana L. Hincapie

  2. Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia

    Marwan Alrasheed

  3. School of Human Services, University of Cincinnati, Cincinnati, OH, 45221-0068, USA

    Angelica Hardee

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Correspondence to Marwan Alrasheed.

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The authors received no financial support for the research, authorship, and/or publication of this article.

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The authors have no competing interests to declare that are relevant to the content of this article.

Ethics approval

Exempted from University of Cincinnati Institutional Review Board review (FWA: #000003152).

Consent to participate

Not applicable for the current study. Protocols for the original studies can be accessed through NIDDK Central Repository.

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Not applicable for the current study. Protocols for the original studies can be accessed through NIDDK Central Repository.

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Data provided by NIDDK Central Repository. Authors have no right to share data according to the data use agreement.

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Author contributions

Conceptualization: MA and AH. Data curation: MA. Formal analysis: MA. Methodology: MA, AH, JG, AL, AH, and PW. Original draft preparation: MA. Writing—review and editing: MA, AH, JG, AL, AH, and PW.

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Alrasheed, M., Guo, J.J., Lin, A.C. et al. Association between polypharmacy, patient-reported symptoms, and quality of life among nonalcoholic fatty liver disease patients in the United States. Drugs Ther Perspect 38, 490–498 (2022). https://doi.org/10.1007/s40267-022-00957-z

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