This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.
ObjectivesTo identify the independent risk factors of primary non-adherence to chronic concomitant treatment in HIV-positive patients, and to measure primary and secondary non-adherence rates to chronic treatments, and secondary non-adherence to antiretroviral therapy and the prevalence of concomitant chronic diseases.MethodsWe conducted a retrospective study that included HIV-infected patients with antiretroviral treatmentwho attended the pharmaceutical care office between January and December 2012. The dependent variable was primary non-adherence to concomitant prescription drugs for chronic diseases. To know the predictors of concomitant primary non-adherence, we performed a univariate analysis and a multivariate binary logistic regression model to identify the independent predictors of primary non-adherence to co-medication.ResultsOut of 598 patients analysed, 333 patients had a new co-medication prescribed during the studied period. The number of comorbidities per patient was 2.3 and the patients were treated with an average of 3.4 drugs. The rates of primary and secondary non-adherence to co-medication were 8.4% and 44.4%, respectively. The co-occurrence of primary and secondary non-adherence was 24.9%. The number of comorbidities (p=0.001) and co-medications (p=0.001) was significantly higher in patients who had primary non-adherence to co-medication. Furthermore, there was a statistically significant relationship between primary non-adherence and patients treated with psychotropic drugs (p=0.03). The multivariate analysis showed the independent predictor of primary non-adherence to co-medication was the number of co-medications (p<0.001).ConclusionOne-third of new concomitant medications prescribed to HIV-positive patients were never filled from the pharmacy. The number of co-medications was identified as a predictor of primary non-adherence to chronic concomitant treatment in HIV-infected population.
BackgroundImatinib has a high likelihood of drug interactions due to hepatic oxidative metabolism.PurposeTo evaluate the incidence and severity of interactions between imatinib and home treatment of oncohaematology patients.Material and methodsRetrospective observational study of oncohaematology patients treated with imatinib between January and March 2014. The following data were collected: age, sex, diagnosis, date of start and end of treatment with Imatinib and concomitant prescribed medicines. Imatinib interactions with other drugs were assessed by the software tool Micromedex 2.0. These were classified as: contraindicated, severe, moderate and mild.Results24 patients were included. 58% were men (n = 14) with a mean age of 61 years. The main indication for imatinib was chronic myeloid leukaemia (54%). 164 prescriptions were analysed. The most prescribed therapeutic groups were: analgesics (19%), antidepressants and anxiolytics (16%), antihypertensives (11%) and gastric protectors (10%). 16 interactions between imatinib and concomitant treatment were detected, affecting 50% of patients. 69% were severe interactions and 31% moderate interactions. 6 patients had one severe interaction, 2 had two severe interactions, 1 patient suffered a severe and a moderate interaction and 2 patients each had two moderate interactions. Severe interactions were due to paracetamol (n = 8), acenocoumarol (n = 2) and amiodarone (n = 1). Moderate interactions were for itraconazole (n = 2), tamsulosin (n = 1), ketoconazole (n = 1) and levothyroxine (n = 1). The effect of severe interactions was reviewed and no clinical relevance was detected to date. These patients were selected for special monitoring by the pharmacist.ConclusionLike other studies on the subject, our study shows that there are numerous interactions between imatinib and other drugs. The interactions detected are severe or moderate. It is important to keep track of patients treated with imatinib who take paracetamol due to the very frequent use of this drug.ReferenceFarm Hosp 2014;38(4):338–363No conflict of interest.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.