Association between health-related quality of life and medication discrepancies: a cross-sectional study of older Chinese adults with type 2 diabetes mellitus

BACKGROUND: Health-related quality of life (HRQoL) is a widely used indicator for assessing individuals' subjective perception of life quality and population health status. It evaluates the multiple dimensions related to health, including physical, psychological, and social aspects, and may be associated with self-management behaviors and treatment adherence in patients with chronic diseases. This study examines the association between HRQoL and medication discrepancies (MDs) among older adults with type 2 diabetes mellitus (T2DM) during the transition from hospital to home care. METHODS: The cross-sectional survey was conducted in Baoding City, Hebei Province, China. Data from patients (N = 552) were collected using a questionnaire that included the Chinese version of the MOS 36-Item Short Form Health Survey, a sinicized and modified version of the Medication Discrepancy Tool, and a general information form. Descriptive statistics, logistic regression models, and generalized additive models were employed to examine the associations between the variables. RESULTS: The prevalence of MD in the study population was 55.8%. After adjustment for sociodemographic, clinical, and medication-related characteristics, both the Physical Component Summary and Mental Component Summary scores were significantly associated with MD. In the adjusted analyses, the medium-score group showed the highest odds of MD, followed by the high-score group, whereas the low-score group showed the lowest odds. CONCLUSIONS: HRQoL is associated with MD among older adults with T2DM during the post-discharge care transition, with a non-monotonic pattern in which MD prevalence peaks in the moderate HRQoL range. Solely disease severity-based models may overlook the relevance of subjective health perceptions in relation to medication behaviors. These findings suggest that HRQoL warrants consideration in understanding medication safety during care transitions, though the conclusions await confirmation in prospective studies.