Polypharmacy and drug-related problems among people living with HIV/AIDS: a single center experience

Abstract

Background/aim: The HIV-infected population is aging, and the concomitant comorbidities increase the likelihood of polypharmacy. There is a scarcity of data for determining drug-related problems in people living with HIV/AIDS (PLWHA). Materials and methods: This cross-sectional study was carried out between September 1, 2015, and July 1, 2016. All patients underwent a face-to-face interview with a clinical pharmacist. The 'PCNE Classification V 7.0.' was used classify incident drug-related problems (DRPs). Results: The mean age of the patients was 40.4±13.06 years. The rate of polypharmacy was 66.1% in patients with comorbidities and 12.3% in those without comorbidities (p<0.001). DRPs were more prominent in older patients (46 vs. 37 years, p<0.001), with longer duration of antiretroviral therapy (ART) (45 vs. 27 months, p=0.014), and with lower education level (p=0.013). Receiving >3 ART drugs was associated with more DRPs in the logistic regression model (odds ratio: 8.299, 95% confidence interval: 1.924–35.803). Fifty-eight interventions were performed in 45 (24.9%) patients. Clinical pharmacist interventions were performed in 18.9% of patients without polypharmacy and in 38.9% of patients with polypharmacy (p<0.001). Conclusion: DRPs and polypharmacy are common among elderly PLWHA. More interventions are warranted to boost the quality of life in aging PLWHA. Keywords: human immunodeficiency virus, polypharmacy, drug-related problems

What is Polypharmacy In People Living With HIV/AIDS? A Systematic Review

“…There was a total of 36 de nitions of polypharmacy, with studies further divided based on the magnitude of polypharmacy (Table 1); minor polypharmacy (N = 3); major polypharmacy (N = 29); "severe" polypharmacy (N = 2); "excessive" polypharmacy (N = 1); "higher" polypharmacy (N = 1) (Table 2). Major 29 [2], [6], [8], [15], [17][18][19][20][21][22][23][24][25][26][27][28][29], [31][32][33][34][35][36][37][38][39][40] Severe 2 [23] [26] [39] Excessive 1 [11] Higher 1 [39] Duration of Polypharmacy Amongst the included studies, 16% (N = 5) incorporated the duration of treatment to the de nition of polypharmacy, while a signi cant proportion 84% (N = 26) only provided the numerical de nition of polypharmacy with no additional information on its duration. Gimeno-Gracia et al further strati ed drug exposure based on the following duration: greater than 1 day; greater than 90 days; and greater than 180 days [14,36].…”

“…For instance, Nozza et al [20], Guaraldi et al [17], and Alleman et al [30] all included a duration of 4 months While the majority (67.7%) of studies included in our review only comprised non-ART medications in their de nitions of polypharmacy, a signi cant proportion (27%) embraced both ART and non-ART medications. Kara et al [18] included both categories in their de nition of polypharmacy, while Halloran et al [6] only involved non-ART; although both studies had the same numerical de nition for polypharmacy (5 or more medications). A patient taking three ART and three non-ART medications will meet the criteria for polypharmacy according to Kara et al but not Halloran et al Consistency with regards to the classes of medications included in the de nition of polypharmacy is essential.…”

Drug therapy problems identified among patients receiving antiretroviral treatment in a HIV clinic: a prospective study in North Central, Nigeria

“…For example, in a cross-sectional study, Kara et al . reported that the prevalence rate of polypharmacy was 30% among 181 outpatients in Turkey [ 28 ]. However, the 58 identified drug therapy problems were clustered among 45 patients.…”

“…Hence, identification of at-risk patients is an important first step to addressing drug therapy problems. Studies show that age, duration of antiretroviral therapy (ART), intensive ART, and polypharmacy are significant predictors of drug therapy problems among patients with HIV [ 28 , 30 ].…”

Interações medicamentosas entre pacientes com HIV/AIDS

“…A polifarmácia, isto é, o uso simultâneo de vários medicamentos, tem aumentado os impasses no cuidado de pessoas com comorbidades (Hasler et al, 2015). Em suma, a polifarmácia ou polimedicação estão relacionadas com a maior complexidade ao combinar um tratamento terapêutico (Bastida et al, 2017).Portanto, pode causar a redução na adesão ao tratamento e reações adversas conforme os medicamentos utilizados e, quando utilizada com a intenção de elevar a eficácia terapêutica, pode acontecer as IM trazendo prejuízos à saúde, os eventos adversos e sua gravidade associados com a IM se intensificam principalmente pelo uso de um maior número de fármacos, além de fatores individuais, como idade avançada e presença de comorbidades (Kara et al, 2019;Andrade & Souza, 2018).…”