Work

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

Year: 2025

Type: review

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.

Source: European Geriatric Medicine

DOI: 10.1007/s41999-025-01175-2

Authors: Cheima Amrouch, Deirdre A. Lane, Amaia Calderón-Larrañaga, Mirko Petrovic, Delphine De Smedt, the AFFIRMO investigators