High level of medication regimen complexity index correlate with worse quality of life in people living with HIV

Contreras-Macías, Enrique; Gutiérrez‐Pizarraya, Antonio; Robustillo-Cortés, María Aguas; Morillo-Verdugo, Ramón

doi:10.37201/req/097.2020

Cited by 13 publications

(7 citation statements)

References 25 publications

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“…Notably, as shown in the adjusted analysis, very complex regimens were associated with poorer adherence, regardless of the number of drugs, since schemes with the same amount of drugs may present different degrees of complexity, as assessed by the MRCI, due to other aspects evaluated by the tool 23 . It should be noted, for example, that carelessness with the administration schedules of medications has been mentioned as an essential factor that impacts treatment adherence 19, 24 .…”

Section: Discussionmentioning

confidence: 86%

Factors associated with adherence to pharmacological treatment in hypertensive patients enrolled in the HIPERDIA program

et al. 2022

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Objective: To assess adherence to antihypertensive treatment in patients at a Family Health Strategy (FHS) unit. Methods: quantitative, transversal, and observational study with 131 hypertensive patients registered in the HIPERDIA program of an FHS located in the city of Lagarto, Sergipe, Brazil, through the analysis of medical records and the application of structured questionnaires. The assessment of the degree of adherence was carried out through the Brief Medication Questionnaire. Results: Factors related to poor adherence were illiteracy (PR: 0.61; 95%CI: 0.42 - 0.89), per capita family income < 1 minimum wage (PR: 0.51; 95%CI : 0.33 - 0.78) and high pharmacological complexity (PR: 0.66; 95%CI: 0.45 - 0.97), while only regular physical activity (PR: 2.64; 95%CI: 1.28 - 5.46) and a good quality of life (PR: 1.44; 95%CI: 1.02 - 2.04) remained positively associated with adherence. Conclusion: As these are modifiable factors, the simplification of the therapeutic scheme and the regular practice of physical activity are key points for increasing adherence to the treatment of systemic arterial hypertension in Primary Care.

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Section: Discussionmentioning

confidence: 86%

Factors associated with adherence to pharmacological treatment in hypertensive patients enrolled in the HIPERDIA program

et al. 2022

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“…Analysis using the t-student test showed a statistically significant relationship between MRCI score and the sum of the STOPP-Beers criteria with increasing age ( p < 0.05) The generalisability of the study findings is reduced by the single-centre study design and small sample size. Moreover, the STOPP-Beers criteria were validated to non-HIV patients 65 years or older Contreras-Macias et al, 2021 (Spain) [ 70 ] n = 428 M = 50 years (SD = 10.9) Outpatient Data were collected using the Capacity-Motivation-Opportunity pharmaceutical care model at routine follow-up appointments Medication Regimen Complexity Index (MRCI) and the EQ-5D-5L questionnaire Polypharmacy was identified in 25.9% (111) of participants, with 5.4% (23) being on 11 or more medications. A negative correlation between ED-5D and MRCI scores was identified ( p = 0.0002).…”

Section: Resultsmentioning

confidence: 99%

“…The presence of one or more co-morbidities also increases the risk of falls in PLWH [ 50 ]. Among older PLWH, poor HRQOL is associated with co-morbidities, especially AIDS-defining illnesses, longer time since ART initiation, loneliness and a lower level of education [ 26 , 54 , 62 , 65 , 68 – 70 ]. A study focusing on women living with HIV showed that physical HRQOL was lower in older participants than in younger age groups [ 69 ].…”

Section: Resultsmentioning

confidence: 99%

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Ageing with HIV: Medicine Optimisation Challenges and Support Needs for Older People Living with HIV: A Systematic Review

et al. 2023

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Background Older people living with HIV (PLWH) are at increased risks of co-morbidities and polypharmacy. However, little is known about factors affecting their needs and concerns about medicines. This systematic review aims to describe these and to identify interventions to improve medicine optimisation outcomes in older PLWH. Methods and Data Sources Multiple databases and grey literature were searched from inception to February 2022 including MEDLINE, CINAHL, PsycInfo, PsychArticles, the Cochrane Database of Systematic Reviews and the Cochrane Controlled Register of Trials, Abstracts in Social Gerontology, and Academic Search Complete. Eligibility Criteria Studies reporting interventions/issues affecting older PLWH (sample populations with mean/median age ≥ 50 years; any aspect of medicine optimisation, or concerns). Quality assessments were completed by means of critical appraisal checklists for each study design. Title and abstract screening was led by one reviewer and a sample reviewed independently by two reviewers. Full-paper reviews were completed by one author and a 20% sample was reviewed independently by two reviewers. Synthesis Data were extracted by three independent reviewers using standardised data extraction forms and synthesised according to outcomes or interventions reported. Data were summarised to include key themes, outcomes or concerns, and summary of intervention. Results Seventy-nine ( n = 79) studies met the eligibility criteria, most of which originated from the USA ( n = 36). A few studies originated from Australia ( n = 5), Canada ( n = 5), Spain ( n = 9), and the UK ( n = 5). Ten studies originated from Sub-Saharan Africa (Kenya n = 1, South Africa n = 6, Tanzania n = 1, Uganda n = 1, Zimbabwe n = 1). The rest of the studies were from China ( n = 1), France ( n = 1), Germany ( n = 1), Italy ( n = 1), the Netherlands ( n = 1), Pakistan ( n = 1), Switzerland ( n = 1), Saudi Arabia ( n = 1) and Ukraine ( n = 1). Publication dates ranged from 2002 to 2022. Sample sizes ranged from 10 to 15,602 across studies. The factors affecting older PLWH’s experience of and issues with medicines were co-morbidities, health-related quality of life, polypharmacy, drug interactions, adverse drug reactions, adherence, medicine burden, treatment burden, stigma, social support, and patient-healthcare provider relationships. Nine interventions wer...

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“…In our study, almost half of the patients present a high complexity index, with a median of 11.0 points. There are other published studies, such as the one by Contreras et al [ 34 ], where a lower mean complexity index (6.9 points), with 20.6% of patients with a high complexity index. This difference may be due to the fact that the study was carried out in HIV patients older than 18 years.…”

Section: Discussionmentioning

confidence: 99%

Potentially inappropriate medications according to Marc, STOPP and PRISCUS criteria in a cohort of elderly HIV+ patients. The COMMPI project

García-Lloret¹,

Borrego-Izquierdo²,

Manzano-García³

et al. 2022

Rev Esp Quimioter

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Introduction. The objective is to determine the prevalence of potentially inappropriate drugs according to the Marc, STOPP, and PRISCUS lists in elderly HIV patients. Patients and methods. It was an observational, retrospective, and multicenter study. People living with HIV 65 years or older who underwent chronic concomitant treatment were included. Descriptive and multivariate analyzes were performed to study the association between polypharmacy and potentially inappropriate medication compliance. Results. A total of 55 patients were included, 81.8% men and a median age of 69 years (IQR: 67-73). The median number of comorbidities was 3 (IQR: 2-5) and the most frequent pattern of multimorbidity was cardiometabolic (62.9%). The predominant antiretroviral treatment was triple therapy (65.5%). Polypharmacy was present in 70.9% of the patients and 25.5% had major polypharmacy. The most frequent polypharmacy pattern was cardiovascular (69.2%). The percentage of potentially inappropriate medications according to the Marc, STOPP and PRISCUS lists was 65.5%, 30.9% and 14.5%, respectively (p<0.001). Adjusted for age and sex, polypharmacy was not independently associated with potentially inappropriate medication compliance in any of the lists. Conclusion. Polypharmacy and potentially inappropriate medications have a high prevalence. There is great variability in the percentage according to the list applied. Age, sex, and presence of polypharmacy are not predisposing factors to the presence of potentially inappropriate medications.

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High level of medication regimen complexity index correlate with worse quality of life in people living with HIV

Cited by 13 publications

References 25 publications

Factors associated with adherence to pharmacological treatment in hypertensive patients enrolled in the HIPERDIA program

Factors associated with adherence to pharmacological treatment in hypertensive patients enrolled in the HIPERDIA program

Ageing with HIV: Medicine Optimisation Challenges and Support Needs for Older People Living with HIV: A Systematic Review

Potentially inappropriate medications according to Marc, STOPP and PRISCUS criteria in a cohort of elderly HIV+ patients. The COMMPI project

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