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Health-related Quality of Life Among Older Adults Following Acute Hospitalization: Longitudinal Analysis of a Randomized Controlled Trial

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Journal Qual Life Res
Date 2024 Jun 17
PMID 38884880
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Abstract

Purpose: To describe the longitudinal change of health-related quality of life (HRQoL) over 12 months from acute hospitalization in older adults ≥ 70 years (IMMENSE study), and associated factors, to investigate how a medication optimization intervention influenced this change.

Methods: The EQ-5D-3L was used at discharge and 1, 6 and 12 months after discharge during a randomized controlled trial including 285 participants. Multilevel logistic (EQ-5D-3L dimensions) and mixed model regression (EQ-5D-3L index scores, EQ-VAS) were used to explore the longitudinal change with/without the intervention, and associations with medications, comorbidities, and socioeconomic variables. Subgroup analyses were performed for non-long and long stayers with hospitalizations < or ≥ 14 days.

Results: EQ-5D-3L index scores significantly declined after 12 months (β -0.06 [95% confidence interval (CI:) -0.10--0.02], p = 0.003). Non-long stayers showed significant improvement 1 month from discharge (β 0.05 [0.00-0.09], p = 0.040). The number of medications and receiving home-care services were the main factors associated with reduced HRQoL. Being home-dwelling was the main factor associated with higher HRQoL. Non-long stayers of the intervention group reported significantly higher EQ-VAS than the control group (β 4.02 [0.11-7.93], p = 0.044).

Conclusion: We observed no significant difference in the longitudinal change in HRQoL between the two IMMENSE study groups over 12 months after hospitalization. However, the non-long stayer subgroup analysis indicates that the intervention may have had a long-term effect on HRQoL in some of intervention patients. The number of medications and the ability to live and care for oneself should be taken into consideration when planning future patient care and health-care services.

Trial Registration: The trial was registered in clinicaltrials.gov on 28/06/2016 before enrolment started (NCT02816086).

Citing Articles

Investigating the impact of a pharmacist intervention on inappropriate prescribing practices at hospital admission and discharge in older patients: a secondary outcome analysis from a randomized controlled trial.

Garcia B, Omma K, Smabrekke L, Johansen J, Skjold F, Halvorsen K Ther Adv Drug Saf. 2024; 15:20420986241299683.

PMID: 39555108 PMC: 11569490. DOI: 10.1177/20420986241299683.

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