Primary aim was to assess prevalence and severity of potential and real drug–drug interactions (DDIs) among therapies for COVID-19 and concomitant medications in hospitalized patients with confirmed SARS-CoV-2 infection. The secondary aim was to analyze factors associated with rDDIs. An observational single center cohort study conducted at a tertiary hospital in Spain from March 1st to April 30th. rDDIs refer to interaction with concomitant drugs prescribed during hospital stay whereas potential DDIs (pDDIs) refer to those with domiciliary medication. DDIs checked with The University of Liverpool resource. Concomitant medications were categorized according to the Anatomical Therapeutic Chemical classification system. Binomial logistic regression was carried out to identify factors associated with rDDIs. A total of 174 patients were analyzed. DDIs were detected in 152 patients (87.4%) with a total of 417 rDDIs between COVID19-related drugs and involved hospital concomitant medication (60 different drugs) while pDDIs were detected in 105 patients (72.9%) with a total of 553 pDDIs. From all 417 rDDIs, 43.2% (n = 180) were associated with lopinavir/ritonavir and 52.9% (n = 221) with hydroxychloroquine, both of them the most prescribed (106 and 165 patients, respectively). The main mechanism of interaction observed was QTc prolongation. Clinically relevant rDDIs were identified among 81.1% (n = 338) (‘potential interactions’) and 14.6% (n = 61) (contraindicated) of the patients. Charlson index (OR 1.34, 95% IC 1.02–1.76) and number of drugs prescribed during admission (OR 1.42, 95% IC 1.12–1.81) were independently associated with rDDIs. Prevalence of patients with real and pDDIs was high, especially those clinically relevant. Both comorbidities and polypharmacy were found as risk factors independently associated with DDIs development.

BackgroundThere has been an increase in the number of chronic conditions concomitantly present in HIV-infected individuals and correspondingly, in comedication. Beliefs play a crucial role in medicines adherence.PurposeTo investigate the relationship between beliefs (necessity and concerns) of HIV-infected patients about comedication and their adherence.Material and methodsWe conducted a cross-sectional study between May–July 2014, that included HIV-infected patients treated with antiretroviral treatment (ART) and ≥1 additional drugs for other chronic diseases.The variables analysed in the study were demographics (sex, age), mode of transmission, CD4+, HIV plasma viral load, beliefs about comedication and adherence to treatment for chronic conditions.The Beliefs about Medicines Questionnaires (BMQ) was used to assess patients’ beliefs about drugs for additional diseases. The BMQ-Specific has two scales (necessity and concern) with five questions each that uses a 5-point Likert scale (1 = strongly disagree, 2 = disagree, 3 = uncertain, 4 = agree, 5 = strongly agree). A total score per scale was calculated. Self-reported comedication adherence was measured using the 4-item Morisky Medication Adherence Scale (MMAS). MMAS scores were dichotomised into adherent/non-adherent.Internal consistency within BMQ scales was measured with Cronbach’s α and their association with adherence was assessed with t-Student tests, using SPSS 20.0.ResultsWe included 126 patients (80.4% male, mean age 50.4 ± 8.3). Injected drug use was the main mode of transmission. 43.7% of patients presented CD4+ ≤ 500 cells/mm3 and 25.4%, detectable viral load. The mean number of additional medicines was 2.9 ± 2.0.The percentage of non-adherent patients was 54.0%. Belief in necessity was positively related to self-reported adherence. No relationship between adherence and concern was found. Internal consistency for BMQ-Specific was high (Cronbach’s alfa = 0.724) which indicates high intercorrelation between items.Abstract CP-025 Table 1BMQ-Specific scale> Cronbach´s alfa Non-Adherent (Mean±SD)Adherent (Mean±SD) p-value Necessity0.79417.3 ± 5.618.8 ± 4.40.188Concern 0.785 14.6 ± 5.7 12.1 ± 6.1 0.019ConclusionGreater conviction that comedication is necessary was associated with higher self-reported adherence in HIV infected-patients, suggesting that it could be important to focus on the necessity of this treatment to improve adherence.References And/or AcknowledgementsPlos One 2013;8(12):e80633No conflict of interest.

Background The number of HIV infected patients with other comorbidities is growing due to increased life expectancy. So many patients have very complex therapeutic regimens that could interfere with adherence. Purpose To determine the effect of the complexity of the drug regimen on the adherence to antiretroviral treatment (ART) and lipid-lowering treatment (LLT). Materials and methods We conducted a single-centre, retrospective study. We included HIV infected patients with ART and treatment for dyslipidaemia between January–June 2013. The dependent variable was the adherence (ART and LLT) and the independent variables were: sex, age, route of HIV transmission, HCV coinfection, alcohol consumption or illegal drug abuse, psychiatric disease and complexity of the drug regimen. Adherence was determined through pharmacy dispensing records. Patients were considered adherent when they took ≥90% of prescribed ART and LLT in the last 3 months. Drug regimen complexity was determined through the tool “medication regimen complexity index” (MRCI) developed by McDonald et al1. To determine the variables associated with adherence, we performed a univariate logistic regression analysis. Results We included 55 patients in the study (82% men, mean age 55 years). Sexual was the main route of HIV transmission (40%). 52.7% were co-infected with HCV, and 15% of patients used alcohol or illegal drugs. Atorvastatin was the LLT most frequently prescribed. 82% of patients were adherent to ART, but only 69% presented undetectable HIV-RNA. On the other hand, 51% of patients were adherent to LLT. MRCI was not a predictive factor for non-adherence. Alcohol consumption or illegal drug abuse was the only variable that showed statistically significant relationships with the non-adherence to ART (p = 0.013). Adherence to ART in this group of patients was 40% vs. 90.9% in the other group (not consuming alcohol or illegal drugs). Conclusions In this study the complexity of the drug regimen was not a predictive factor for adherence in HIV infected patients. Alcohol consumption or illegal drug abuse could lead to a lack of adherence. Hospital pharmacists play a key role in adherence to ART and this study showed a high adherence to ART. However, at present many patients have other prescription drugs for other comorbidities. In this study the adherence to LLT is low. Therefore, hospital pharmacists should try to ensure adherence to all the medicines and not only to ART. Reference McDonald MV, Peng TR, Sridharan S, Foust JB, Kogan P, Pezzin LE, Feldman PH. Automating the medication regimen complexity index. J Am Med Inform Assoc 2013. 1;20:499-505. No conflict of interest.

BackgroundComorbid chronic conditions have increased among HIV-infected patients. Little work has studied adherence rates for long-term medicines (LTMs).PurposeTo assess adherence to other LTMs (non-antiretroviral therapy) among HIV-infected patients as well as to evaluate its relationship with clinical and therapeutic factors.Material and methodsA cross-sectional study was conducted from May to July 2014 in HIV-infected patients treated with ART and ≥1 LTM. The following variables were collected: sex, age, living situation, employment status, mode of transmission, T-CD4, viral load, CDC classification, type of ART and adherence to other LTM (non-antiretroviral treatment), using the 4-item Morisky Medication Adherence Scale. The chi-squared test was applied to examine the role of the different variables on adherence, using SPSS 20.0.Results126 patients were included (80.4% male, mean age 50.4 ± 8.3). Injection drug use was the main mode of transmission (61.9%). The median T-CD4 was 538.5 cells/mm3 (IQR: 341.1–778.2). Most of patients presented T-CD4 ≥ 500 cells/mm3 (56.3%) and undetectable viral load (74.6%). 63.5% of them had AIDS. ART was mainly (36.5%) two nucleoside/nucleotide reverse transcriptase inhibitors (NRTIs) with one non-nucleoside reverse transcriptase inhibitor (NNRTI). The percentage of patients adherent to other LTMs (non-antiretroviral therapy) was 46.0%. The variable AIDS exhibited a statistically significant relationship with non-adherence (OR = 2.2; CI [1.1–4.7]; p = 0.041). The most common long-term medicines were sedatives and anxiolytics (42.9%), lipid-lowering drugs (35.7%), antihypertensives (33.3%), gastrointestinals (28.6%), antidepressants (15.1%), antidiabetics (12.7%), analgesics (11.1%), antiasthmatics (9.5%) and cardiovascular drugs (87.9%).Abstract CP-010 Table 1Variable: n (%)Non-Adherent (n = 68)Adherent (n = 58)p-ValueAge ≥ 50 years30 (44.1)26 (44.8)1.000Gender: female14 (20.6)12 (20.7)1.000Living alone18 (26.5)11 (19.0)0.399Employment status: employed16 (23.5)19 (32.8)0.399Mode of transmissionSexualInjection drug use21 (30.9)47 (69.1)27 (46.6)31 (63.4)0.097Detectable viral load (>20 copias/ml)18 (26.5)14 (24.1)0.839T-CD4 ≥ 500 Cells/mm3 38 (55.9)33 (56.9)1.000AIDS49 (72.1)31 (53.4)0.041Type of ART2NRTIs + NNRTI2NRTIs + IP/rOthers25 (36.8)20 (29.4)23 (33.8)21 (36.2)21 (36.2)16 (27.6)0.657ConclusionPatients showed a low level of adherence to other LTMs. This study allowed us to attempt to educate HIV-infected patients with suboptimal adherence.References and/or acknowledgementsCantudo-Cuenca MR, Jiménez-Galán R, Almeida-Gonzalez CV, et al. Concurrent use of comedications reduces adherence to antiretroviral therapy among HIV-infected patients. J Manag Care Pharm 2014;20(8):844–50No conflict of interest.