Objective: To determine the frequency of drug therapy problem in the treatment of patients with tuberculosis and HIV/AIDS. Methods: Data were obtained through a cross-sectional study conducted between September 2015 and December 2016 at a reference hospital in infectious diseases in Belo Horizonte (MG), Brazil. Sociodemographic, clinical, behavioral and pharmacotherapeutic variables were evaluated through a semi-structured questionnaire. Drug-related problems of pharmaceutical care were classified using the Pharmacotherapy Workup method. Factors associated with indication, effectiveness, safety and compliance drug therapy problem were assessed through multiple logistic regression. Results: We evaluated 81 patients, and 80% presented at least one drug therapy problem, with indication and adherence drug therapy problem being the most frequent. The factors associated with drug therapy problem were age, marital status, new case, ethnicity, time of HIV diagnosis and time to treat tuberculosis. Conclusion: The frequency of drug therapy problem in coinfected patients was high and the identification of the main drug therapy problem and associated factors may lead the multiprofessional health team to ensure the use of the most indicated, effective, safe and convenient medicines for the patients clinical condition. Tuberculosis and HIV/AIDS coinfected individuals aged over 40 years are more likely to have drug therapy problems during treatment; in that, the most frequente are those that signal toward need of medication for an untreated health condition and non-compliance to treatment. Thus, older patients, unmarried or married, who have treated tuberculosis before, with a shorter time to tuberculosis treatment and longer time to diagnose HIV/AIDS, should receive special attention and be better followed by a multiprofessional health team because they indicate a higher chance of presenting Problems related to the use of non-adherent drugs.

Pharmaceutical care is a professional practice seeking the responsible provision of drug therapy by identifying, resolving, and preventing Drug-Related Problems (DRP). The study aims to describe and evaluate the impact of pharmaceutical care given to patients being treated for tuberculosis (TB). Study concurrent, longitudinal, prospective conducted during pharmaceutical care in the TB outpatient clinic, Clinical Hospital, Federal University of Minas Gerais during the period August 2009 to July 2012. The Pharmacotherapy Workup proposed by Cipolle et al. (2004) was used. Statistical analyses were performed by X 2 or Fisher exact test, as appropriate. A total of 62 patients were followed up, and 128 drug-related problems (DRP) were identified: 69.5% related to safety, 13.3% to effectiveness, 12.5% to indication, and 4.7% to treatment adherence, and 62.1% of the DRP were resolved. A total of 115 pharmaceutical interventions were performed. The impact of pharmaceutical care was satisfactory for 73.9% of patients with a resolution rate of 77%. There was a greater impact on pharmaceutical care (index ≥ 0.50) for those patients who were not smokers (p <0.05). The impact of pharmaceutical care was important, so the pharmacist should work alongside the multidisciplinary team to monitor treatment and perform interventions.

Introduction: The concomitant use of antituberculosis and antiretroviral drugs, as well as drugs to treat other diseases, can cause drug-drug interactions. This study aimed to describe potential drug-drug interactions (pDDI) in patients with TB and HIV/AIDS co-infection, as well as to analyze possible associated factors. Methods: This study was performed in a reference hospital for infectious and contagious diseases in the southeastern region of Brazil and evaluated adult patients co-infected with tuberculosis and HIV/AIDS. A cross-sectional study was conducted in which sociodemographic, clinical, and pharmacotherapeutic characteristics were assessed. The pDDI were identified using the Drug-Reax software. Association analysis was performed using either a chi-squared test or a Fisher's exact test. Correlation analysis was performed using the Spearman's coefficient. Results: The study included 81 patients, of whom 77 (95.1%) were exposed to pDDI. The most frequent interactions were between antituberculosis and antiretroviral drugs, which can cause therapeutic ineffectiveness and major adverse reactions. A positive correlation was established between the number of associated diseases, the number of drugs used, and the number of pDDI. An association was identified between contraindicated and moderate pDDI with excessive polypharmacy and hospitalization. Conclusions: We found a high frequency of pDDI, especially among those hospitalized and those with excessive polypharmacy. These findings highlight the importance of pharmacists in the pharmacotherapeutic monitoring in these patients.

Tuberculosis (TB) and human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) pharmacotherapy and the stigma related to both diseases are complex. The patients’ subjective experiences with diseases and medications are of utmost importance in pharmaceutical care practice. This study aimed to understand the subjective medication experience of TB and HIV/AIDS coinfected patients. The study was based on descriptive research of a qualitative and quantitative nature using data collected during pharmaceutical care appointments and from medical records from September 2015 to December 2016 at a tertiary infectious diseases referral hospital in Southeastern Brazil. Data from 81 patients were analyzed. Regarding patient subjective medication experience, the following responses to the quantitative questionnaire were most frequent: preference for a route of administration (12.4%) and for non-pharmacological therapy (50.6%); concerns about price (11.1%) and adverse effects (18.5%); and association of a worsening of their health status with a change in medication dosage (23.5%). In the thematic analysis, adversity and socially constructed aspects were more prominent. Resolvability, associated with the patient’s understanding of relief from signs and symptoms and health recovery, was observed; however, feelings of ambivalence permeated the other aspects, hence leading to treatment abandonment. The evaluation of patient medication experience can be a path to understanding and intervening in the phenomenon of treatment abandonment among TB and HIV/AIDS coinfected individuals.

A atenção farmacêutica é a provisão responsável da farmacoterapia e tem o objetivo de alcançar resultados definidos que melhorem a qualidade de vida. Os pacientes com tuberculose, HIV/aids e coinfectados utilizam uma grande quantidade de medicamentos, o que aumenta o risco de apresentarem problemas relacionados ao uso de medicamentos. O objetivo desse trabalho foi verificar as evidências disponíveis na literatura sobre os problemas relacionados ao uso de medicamentos no acompanhamento farmacoterapêutico de pacientes que recebem tratamento para tuberculose, HIV/aids e na coinfecção. Trata-se de estudo de revisão integrativa da literatura, com busca de artigos nas bases de dados literatura latina-americana em ciências e saúde e PubMed. Foram selecionados 18 artigos relacionados ao tema. Em relação à metodologia, oito utilizaram o método Dáder, sete o pharmacist’s workup of drug therapy e três utilizaram outros métodos de classificação de problemas relacionados ao uso de medicamentos. Foram encontrados resultados positivos quando a atenção farmacêutica foi aplicada ao cuidado dos pacientes, identificando menor ocorrência de problemas relacionados ao uso de medicamentos quando havia uma intervenção do farmacêutico com a equipe clínica. Foi observado que a maioria dos problemas relacionados ao uso de medicamentos relatados eram relacionados à segurança do medicamento, seguido de indicação. Estes estudos reforçam a ideia de que a intervenção farmacêutica pode reduzir o número de problemas relacionados ao uso de medicamentos e aumentar a qualidade do cuidado aos pacientes.

Objetivos: Descrever casos de pacientes com coinfecção tuberculose (TB) e HIV/aids acompanhados em um Hospital Referência em doenças infecciosas. Identificar, classificar e resolver os Problemas Relacionados ao uso de Medicamentos (PRM). E classificar a situação clínica e farmacoterapêutica. Métodos: Para a identificação, classificação e resolução do desfecho de PRM bem como a classificação da situação clínica e farmacoterapêutica, utilizou-se a metodologia Pharmacotherapy Workup. Trata-se um estudo observacional, descritivo, longitudinal, do tipo série de casos realizado em Hospital de Referência terciária em Belo Horizonte, seguindo as diretrizes CARE da Enhancing the QUAlity and Transparency Of health Research (EQUATOR). Foram incluídos pacientes coinfectados com TB e HIV/ aids, expostos ao tratamento preconizado pelo Ministério da Saúde, com 18 anos ou mais, de ambos os sexos, acompanhados por um período mínimo de seis meses. Resultados: Foram descritos seis casos de pacientes coinfectados com tuberculose e HIV/aids. A média de encontros com o farmacêutico foi de 6,33 (desvio padrão=0,82). Foram identificados 69 PRM, dos quais 40/69 (58,0%) relacionados à adesão, 17/69 (24,6%) à indicação, 8/69 (11,6%) à segurança e 4/69 (5,8%) à efetividade. Do total de pacientes 4/6 (66,6%) apresentaram hepatotoxicidade durante o acompanhamento. A situação clínica e farmacoterapêutica foi classificada como positiva para todos os pacientes. Conclusão: Houve alto número de PRM de adesão e indicação nos pacientes coinfectados. O monitoramento da efetividade e segurança dos tratamentos deve ser realizado, devido à maior susceptibilidade de reações adversas, como a hepatotoxicidade.

Objectives: This study aims to describe and classify the drugs prescribed for coinfected patients treated at a reference hospital. Methods: A retrospective cross-sectional study with analysis of information contained in a database prepared in an earlier study The Anatomical Therapeutic Chemical (ATC) classification system was used to classify the prescribed drugs. Results: Eighty-one coinfected individuals participated in the study, with a mean age of 40 years old and numerous comorbidities. A total of 147 drugs were found and, when the frequency of prescription was evaluated, the most used therapeutic groups were anti-infectious, considering the large number of opportunistic infections (OIs) presented by coinfected patients, followed by feeding tract drugs used to treat adverse drug reactions. We could observe that 73% of the evaluated population had a CD4+ T lymphocyte count <200 cells/mm3 and a high viral load, indicating advanced immunodeficiency. Conclusion: It is necessary to develop strategies aimed at coinfected patients, such as specialized care, early diagnosis and appropriate treatment of coinfection. It is also important to carry out more studies on the use of drugs among coinfected patients to create actions directed to this population that may contribute to the rational use of drugs.

Integrase Inhibitors are a promising new class of antiretroviral.  However, studies of these drugs in tuberculosis (TB) and, HIV/aids coinfection are scarce. Therefore, the aim of this review was evaluate the efficacy, effectiveness, and safety of integrase inhibitors in the treatment of HIV/AIDS in patients coinfected with tuberculosis (TB). The searches were performed in the MEDLINE, EMBASE, LILACS, COCHRANE, Web of Science, Scopus, and CINAHL databases using the terms “HIV”, “AIDS”, “tuberculosis”, “raltegravir potassium”, “dolutegravir”, “elvitegravir”, “bictegravir”, “integrase inhibitor”, and their respective synonyms. Reports from three randomised clinical trials and a historical cohort were included. Patients coinfected with TB and HIV/AIDS showed a good response to TB treatment (cure or treatment completed), which was above 85% in all arms of the evaluated studies. As a primary outcome, the HIV viral load suppression rates at week 48 were greater than 60% in all arms. The therapies evaluated in patients coinfected with TB and HIV/AIDS were also within the limits of the included studies, there were no significant drug-related adverse events. However, there was no significant difference in the efficacy outcomes viral load suppression between the efavirenz and integrase inhibitor arms, and regarding safety outcomes, there were few events compared with the total. Integrase inhibitors in patients co-infected with TB and HIV/AIDS appear to be effective, well tolerated and constitute an alternative to efavirenz in clinical protocols. However, the use of this drug twice a day compromises adherence to treatment. The role of these drugs should be better determined by further good methodological quality studies to assess their long-term efficacy, effectiveness and safety.