Association between polypharmacy, patient-reported symptoms, and quality of life among nonalcoholic fatty liver disease patients in the United States

Background Nonalcoholic fatty liver disease (NAFLD) is a silent disease, yet patients might report nonspecific symptoms. The objectives of this study were to examine the effect of polypharmacy on patient-reported symptoms in NAFLD adult patients and to examine the impact of patient-reported symptoms on quality of life (QoL). Methods A retrospective observational study was conducted to evaluate NAFLD patient-reported symptoms, QoL, and polypharmacy in the US. QoL was measured using the 36-Item Short Form Survey (SF-36) questionnaire. Patients were classified as having polypharmacy if they used five medications or more. The comparisons of patient-reported symptoms between patients with and without polypharmacy were done using the Wilcoxon Rank Sum Test. To examine each symptom and its effect on QoL, multivariable linear models were performed on QoL scores. Results The study included 1032 patients. The average percentage of reporting “none at all” in patients with polypharmacy was 50%, while it was 66% in the non-polypharmacy group ( p < 0.01). In multivariable linear models, the symptoms that had a negative impact on QoL in terms of physical health were muscle weakness, fatigue, and swelling of ankles ( B = − 13.7, − 9.7, and − 7.914, respectively; all p < 0.01). For mental health, depression/sadness, fatigue, and muscle weakness were the most common symptoms that negatively affected QoL ( B = − 20.3, − 11.2 and − 7.1, respectively; all p < 0.01) Conclusion NAFLD patients with polypharmacy reported more symptoms than NAFLD patients with non-polypharmacy. Fatigue and muscle weakness were the most common symptoms that negatively affected physical health QoL, while depression/sadness and fatigue had a negative impact on mental health QoL.