Assessing forgetfulness and polypharmacy and their impact on health-related quality of life among patients with hypertension and dyslipidemia in Greece during the COVID-19 pandemic

Abstract

Purpose We estimate the association between forgetfulness to take medications as prescribed and polypharmacy and health-related quality of life (HRQoL) among a cohort of patients with hypertension, dyslipidemia or both in Greece during the COVID-19 pandemic. Methods A telephone survey of 1018 randomly selected adults was conducted in Greece in June 2020. Participants were included in the survey, if they (a) had a diagnosis of hypertension, dyslipidemia or both and (b) were on prescription treatment for these conditions. HRQoL was calculated using the short form (SF) -12 Patient Questionnaire. A multivariable generalized linear regression model (GLM) was used to estimate the association between forgetfulness and polypharmacy and HRQoL, controlling for sociodemographic and health-related covariates. Results Overall, 351 respondents met the inclusion criteria, of whom 28 did not fully complete the questionnaire (response rate: 92%, n = 323). Of those, 37% were diagnosed with hypertension only, 28% with dyslipidemia only, and 35% with both. Most reported good to average physical (64.1%) and mental health (48.6%). Overall, 25% indicated that they sometimes forget to take their prescribed medications, and 12% took two or more pills multiple times daily. Total HRQoL score was 68.9% (s.d. = 18.0%). About 10% of participants reported paying less attention to their healthcare condition during the pandemic. Estimates of multivariable analyses indicated a negative association between forgetfulness (− 9%, adjusted β: − 0.047, 95% confidence interval − 0.089 to − 0.005, p = 0.029), taking two or more pills multiple times daily compared to one pill once a day (− 16%, adjusted β: − 0.068, 95% confidence interval − 0.129 to − 0.008, p = 0.028) and total HRQoL. Conclusion Our results suggest that among adult patients with hypertension, dyslipidemia or both in Greece, those who forget to take their medications and those with more complex treatment regimens had lower HRQoL. Such patients merit special attention and require targeted approaches by healthcare providers to improve treatment compliance and health outcomes.

Association between medication adherence and health-related quality of life of patients with diabetes

“…Age and not having children were risk factors of impaired HRQoL but they did not reach statistical significance for health status. In line with previous studies [ 14 , 27 ], better socioeconomic status, i.e., higher education (although not statistically significant for health status) and economic status and being employed, were associated with improved HRQoL and health. Furthermore, a healthier lifestyle, i.e., lower BMI and more physical activity, led to better HRQoL and health, which confirms the value of behavior adjustments in enhancing the well-being of patients with DM [ 27 ].…”

“…In line with previous studies [ 14 , 27 ], better socioeconomic status, i.e., higher education (although not statistically significant for health status) and economic status and being employed, were associated with improved HRQoL and health. Furthermore, a healthier lifestyle, i.e., lower BMI and more physical activity, led to better HRQoL and health, which confirms the value of behavior adjustments in enhancing the well-being of patients with DM [ 27 ]. Interestingly, lower HbA1c values and type 2 diabetes were independently associated with higher VAS levels, while they were not a significant predictor of the EQ-5D index.…”

“…Furthermore, 2.2 and 6.5% had skipped or stopped taking a medicine because they believed that it did not work and due to its side effects, respectively. In a recent study, also conducted during the COVID-19 pandemic, 25.1% of patients with hypertension and dyslipidemia reported that they sometimes forget to take their prescribed medications [ 27 ]. In general, several factors have been identified in the literature as potential barriers to medication adherence, such as the complexity of the medication regimen, patients’ forgetfulness, poor awareness concerning the significance of medication adherence, and negative beliefs or insufficient knowledge about their medications [ 14 , 36 – 39 ].…”

“…Starting in 2014, a series of measures were implemented to expand health coverage to all uninsured citizens, while a full exemption from or a reduction to the co-payments of extremely vulnerable individuals was legislated in 2017 [ 41 ]. However, it should be noted that the above findings may be affected by greater health awareness during the pandemic [ 27 ], although there are also reports of foregoing or postponing necessary treatment during this time period [ 42 ].…”

“…In our study, female participants had lower both HRQoL and health status compared with male patients. It has been suggested that men may cope better with the chronic character of the disease [ 27 ]. Age and not having children were risk factors of impaired HRQoL but they did not reach statistical significance for health status.…”