Number of daily pills, dosing schedule, self‐reported adherence and health status in 2010: a large cross‐sectional study of <scp>HIV</scp>‐infected patients on antiretroviral therapy

Gianotti, Nicola; Galli, Laura; Bocchiola, B; Cahua, T; Panzini, P; Zandonà, D; Salpietro, Stefania; Maillard, Myriam; Danise, Anna; Pazzi, Annamaria; Lazzarin, Adriano; Castagna, Antonella

doi:10.1111/j.1468-1293.2012.01046.x

Cited by 25 publications

(23 citation statements)

References 24 publications

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“…This suggests that what matters is not so much the number of different medications being taken together, rather the number of times each day that medication administration must be coordinated. Other studies looking at management of cardiovascular disease and HIV reach similar conclusions (14)(15)(16)(17)(18). Indeed, one study demonstrated better adherence after adding lipid-lowering treatment to a multidrug treatment regimen in a population with chronic hypertension (19).…”

Section: Discussionmentioning

confidence: 48%

“…The effect on adherence of multiple daily dosing for phosphate binders would be consistent with our findings if the effect was predominantly related to typical dosing frequency. Other positive associations of medication complexity with reduced quality of life (15,17,21) and poor outcome (22) have been reported, but were not explored in this analysis.…”

Section: Discussionmentioning

confidence: 95%

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Medication Treatment Complexity and Adherence in Children with CKD

Blydt-Hansen

Pierce

Cai

et al. 2014

Clinical Journal of the American Society of Nephrology

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SummaryBackground and objectives The complexity of CKD management in children is increased by the number of comorbid conditions. This study assessed the prevalence of comorbidities in pediatric CKD and the frequency with which multiple comorbidities present together by assessing prevalent medication use by CKD stage and diagnosis and their association with clinical or sociodemographic factors. The association between number and frequency of dosing of medications prescribed and self-report of nonadherence was also assessed.Design, setting, participants, & measurements In this cross-sectional analysis of the Chronic Kidney Disease in Children study, medication use at study entry grouped by indication was examined by CKD stage, diagnosis, age, race, ethnicity, income, and CKD duration. Multivariate adjusted predictors of medication use and clustering were examined. Nonadherence was assessed by self-report of missed medications in the past 7 days.Results The 558 eligible participants had a median age of 11 years and median GFR of 44 ml/min per 1.73 m 2 ; 62% of participants were male and 78% had nonglomerular kidney disease. The number of medications for treatment of CKD comorbidities increased with advanced CKD stage (2.5-fold for stages IV versus II; P,0.001) and glomerular disease (1.4-fold versus nonglomerular; P,0.001). Three distinct medication clusters were identified that corresponded to treatment of glomerular disease, advanced renal tubular dysfunction, and proteinuric complications, respectively. Nonadherence was associated with increased medication dosing frequency (administration .2 times/d; P,0.001) but not the number of medications.Conclusions Medical therapy for children with CKD is complex and is affected by glomerular diagnosis, CKD stage, and medication frequency. The need for CKD-related medication treatment cannot be easily predicted by CKD staging alone. Poorer adherence was associated with increased medication frequency, but not with the number of medical problems needing treatment. Consolidating medical treatment and reducing medication frequency may improve adherence rates in children with CKD.

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Section: Discussionmentioning

confidence: 48%

Section: Discussionmentioning

confidence: 95%

Medication Treatment Complexity and Adherence in Children with CKD

Blydt-Hansen

Pierce

Cai

et al. 2014

Clinical Journal of the American Society of Nephrology

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“…21 Single-tablet regimens showed increased adherence rates by calculation of medication possession ratio. 21 Additionally, Gianotti et al (2013) showed an increase in selfreported adherence for patients on single-tablet once-daily HIV regimens. 22 …”

Section: What This Study Addsmentioning

confidence: 99%

“…21 Additionally, Gianotti et al (2013) showed an increase in selfreported adherence for patients on single-tablet once-daily HIV regimens. 22 …”

Section: What This Study Addsmentioning

confidence: 99%

Comparison of Adherence Rates for Antiretroviral, Blood Pressure, or Mental Health Medications for HIV-Positive Patients at an Academic Medical Center Outpatient Pharmacy

Langness¹,

Cook²,

Gill³

et al. 2014

JMCP

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BACKGROUND: Despite advances in safety, tolerability, and decreased pill burden for human immunodeficiency virus (HIV) antiretroviral therapy (ART), nonadherence continues to be a major cause of HIV-related morbidity and mortality. Adherence to these medications presents particular challenges because persons living with HIV (PLWH) must use medication more consistently (≥ 95%) than persons with other chronic diseases, such as hypertension or diabetes mellitus (≥ 80%).

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“…2,[34][35][36] Therefore, we sought to examine the potential impact of polypharmacy on the risk of drug-drug interactions between ARVs and other medications (ARV/non-ARV interactions) in a US cohort of HIV-infected adults seen in the outpatient setting. In particular, we aimed to characterize the extent of polypharmacy, determine the types of medication classes prescribed and rate of prescribed ARV/ non-ARV combinations with the potential for clinically significant interactions among persons of different ages, and identify risk factors for such exposures.…”

Section: Introductionmentioning

confidence: 99%

Polypharmacy and Risk of Antiretroviral Drug Interactions Among the Aging HIV-Infected Population

et al. 2013

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BACKGROUND: Among aging HIV-infected adults, polypharmacy and its consequences have not been welldescribed. OBJECTIVE: To characterize the extent of polypharmacy and the risk of antiretroviral (ARV) drug interactions among persons of different ages. DESIGN AND PARTICIPANTS: Cross-sectional analysis among patients within the HIV Outpatient Study (HOPS) cohort who were prescribed ARVs during 2006-2010. MAIN MEASURES: We used the University of Liverpool HIV drug interactions database to identify ARV/non-ARV interactions with potential for clinical significance. KEY RESULTS: Of 3,810 patients analyzed (median age 46 years, 34 % ≥ 50 years old) at midpoint of observation, 1,494 (39 %) patients were prescribed ≥ 5 non-ARV medications: 706 (54 %) of 1,312 patients ≥ 50 years old compared with 788 (32 %) of 2,498 patients < 50 years. During the five-year period, the number of patients who were prescribed at least one ARV/non-ARV combination that was contraindicated or had moderate or high evidence of interaction was 267 (7 %) and 1,267 (33 %), respectively. Variables independently associated with having been prescribed a contraindicated ARV/non-ARV combination included older age (adjusted odds ratio [aOR] per 10 years of age 1.17, 95 % CI 1.01-1.35), anxiety (aOR 1.78, 95 % CI 1.32-2.40), dyslipidemia (aOR 1.96, 95 % CI 1.28-2.99), higher daily non-ARV medication burden (aOR 1.13, 95 % CI 1.10-1.17), and having been prescribed a protease inhibitor (aOR 2.10, 95 % CI 1.59-2.76). Compared with patients < 50 years, older patients were more likely to have been prescribed an ARV/non-ARV combination that was contraindicated (unadjusted OR 1.44, 95 % CI 1.14-1.82), or had moderate or high evidence of interaction (unadjusted OR 1.29, 95 % CI 1.15-1.44). CONCLUSIONS: A substantial percentage of patients were prescribed at least one ARV/non-ARV combination that was contraindicated or had potential for a clinically significant interaction. As HIV-infected patients age and experience multiple comorbidities, systematic reviews of current medications by providers may reduce risk of such exposures.

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Number of daily pills, dosing schedule, self‐reported adherence and health status in 2010: a large cross‐sectional study of HIV‐infected patients on antiretroviral therapy

Cited by 25 publications

References 24 publications

Medication Treatment Complexity and Adherence in Children with CKD

Medication Treatment Complexity and Adherence in Children with CKD

Comparison of Adherence Rates for Antiretroviral, Blood Pressure, or Mental Health Medications for HIV-Positive Patients at an Academic Medical Center Outpatient Pharmacy

Polypharmacy and Risk of Antiretroviral Drug Interactions Among the Aging HIV-Infected Population

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