Associations Between Polypharmacy, Symptom Burden, and Quality of Life in Patients with Advanced, Life-Limiting Illness

Background Polypharmacy may be particularly burdensome near the end of life, as patients “accumulate” medications to treat and prevent multiple diseases. Objective To evaluate associations between polypharmacy, symptom burden, and quality of life (QOL) in patients with advanced, life-limiting illness (clinician-estimated, 1 month–1 year). Design Secondary analysis of baseline data from a trial of statin discontinuation. Participants Adults with advanced, life-limiting illness. Main Measures Polypharmacy was assessed by summing the number of non-statin medications taken regularly or as needed. Symptom burden was assessed using the Edmonton Symptom Assessment Scale (range 0–90; higher scores indicating greater symptom burden) and QOL was assessed using the McGill QOL Questionnaire (range 0–10; higher scores indicating better QOL). Linear regression models assessed associations between polypharmacy, symptom burden, and QOL. Key Results Among 372 participants, 47% were age 75 or older and 35% were enrolled in hospice. The mean symptom score was 27.0 (standard deviation (SD) 16.1) and the mean QOL score was 7.0 (SD 1.3). The average number of non-statin medications was 11.6 (SD 5.0); one-third of participants took ≥ 14 medications. In adjusted models, higher polypharmacy was associated with higher symptom burden (coefficient 0.81; p