Concurrent Use of Comedications Reduces Adherence to Antiretroviral Therapy Among HIV-Infected Patients

Cantudo-Cuenca, María Rosa; Jiménez-Galán, R; González, C. Almeida; Morillo-Verdugo, Ramón

doi:10.18553/jmcp.2014.20.8.844

Cited by 59 publications

(46 citation statements)

References 39 publications

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“…Even if the data were not statistically significant, they agree with those reported by Cantudo-Cuenca et al ,13 who noted that polymedication is a predictor of non-adherence to ARV treatment. It is important to remember that adherence is a determining factor in the effectiveness of suppressing viral replication, avoiding resistance and minimising co-morbidities 25…”

Section: Discussionsupporting

confidence: 90%

“…According to the definition of the WHO, polypharmacy is ‘the administration of multiple drugs simultaneously’,12 which leads to an increase in likely drug interactions, duplication of treatment and increased adverse effects; polypharmacy is another barrier to therapeutic compliance, as it is associated with increased risk of non-adherence 13. It is estimated that the clinically relevant interactions between ARVs and concomitant medications can reach rates of 20% to 40% and could have fatal consequences 14–15.…”

Section: Introductionmentioning

confidence: 99%

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Analysis of self-reported adverse reactions to efavirenz and drug interactions in a population with HIV in Mexico

Martínez-Salazar

Oaxaca-Navarro²,

Leija

et al. 2017

Eur J Hosp Pharm

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ObjectiveTo analyse the most frequent self-reported adverse reactions (ARs), the durability and the causes of antiretrovirals (ARVs) regimens change, concomitant treatments and drug interactions related to the use of ARVs in a group of people living with HIV in Cuernavaca, Morelos, Mexico.Materials and methodsCross-sectional study conducted in a clinic specialising in HIV ‘CAPASITS-Cuernavaca’ in Mexico from February to June 2015. People who wanted to participate were given a questionnaire on demographic characteristics, adherence, concomitant treatments and ARs. To understand the clinical variables, the clinical records were reviewed. Quantitative variables were compared using Student’s t-test for normal data and the Mann-Whitney U test for non-normal data. For comparisons between categorical variables, the χ2 test was used. All tests used a significance level of 0.05.ResultsA total of 96 people participated, and 218 ARs (mean= 2.3±1.9) were found. The most frequently encountered ARs were dizziness (53.1%), insomnia (21.9%) and lucid dreams (17.7%). Twenty-three people (24%) were polymedicated, and 18 potential interactions were detected in 12 people.ConclusionsThe results suggest that a thorough analysis of the possible drug interactions should be performed for polymedicated people on ARV treatment and that a protocol should be designed for the monitoring and management of AR to ensure a good adherence to ARV treatment.

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Section: Discussionsupporting

confidence: 90%

Section: Introductionmentioning

confidence: 99%

Analysis of self-reported adverse reactions to efavirenz and drug interactions in a population with HIV in Mexico

Martínez-Salazar

Oaxaca-Navarro²,

Leija

et al. 2017

Eur J Hosp Pharm

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“…TWLWH reported lower adherence to medications than non-transgender men, and the difference in adherence between TWLWH and non-transgender women approached statistical significance, supporting past findings (Mizuno et al, 2015; Sevelius et al, 2014; Sevelius et al, 2010). As expected, lower adherence among the TWLWH in this sample was associated with detectable viral loads and failure to achieve viral suppression, further supporting literature that adherence to medications is positively related to virologic outcomes (Cantudo-Cuenca et al, 2014; Mizuno et al, 2015). …”

Section: Discussionsupporting

confidence: 86%

Medication adherence among transgender women living with HIV

2016

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Medication adherence is linked to health outcomes among adults with HIV infection. Transgender women living with HIV (TWLWH) in the U.S. report suboptimal adherence to medications and are found to have difficulty integrating HIV medication into their daily routine, but few studies explore factors associated with medication adherence among transgender women. Thus, the purpose of this paper is to examine demographic and clinical factors related to self-reported medication adherence among transgender women. This secondary analysis is based on data collected from the Symptom and Genetic Study that included a convenience sample of 22 self-identified transgender women, 201 non-transgender men, and 72 non-transgender women recruited in northern California. Self-reported medication adherence was assessed using the AIDS Clinical Trials Group Adherence Questionnaire. Gender differences in demographic and clinical variables were assessed, as were differences between transgender women reporting high and low adherence. Transgender women had lower adherence to medications compared to non-transgender males and non-transgender females (p=.028) and were less likely to achieve viral suppression (p=.039). Within the transgender group, Black/African Americans reported better adherence than participants who were Whites/Caucasian or other races (p=.009). Adherence among transgender women was unrelated to medication count and estrogen therapy, but consistent with other reports on the HIV population as a whole; transgender women with high adherence were more likely to achieve viral suppression compared to the transgender women with low adherence. Despite the high incidence of HIV infection in the transgender population, few studies focus on TWLWH, either in regard to their adherence to antiretroviral therapies or to their healthcare in general. To address ongoing health disparities, more studies are needed focusing on the transgender population’s continuum of care in HIV therapies.

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“…Cantudo-Cuenca et al 20 reported that the use of multiple medications increases the risk of non-adherence and therefore it may increase the risk of hospital admission. Polypharmacy seems to be the next therapeutic challenge in HIV patients 21–23…”

Section: Discussionmentioning

confidence: 99%

Design and validation of a predictive model for 1-year hospital admission in HIV patients on antiretroviral treatment

et al. 2016

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ObjectivesTo develop and validate a model for predicting the risk of hospital admission within 1 year in the HIV population under antiretroviral treatment.MethodsWe conducted a retrospective observational study. Patients receiving antiretroviral treatment for at least 1 year who were followed by the pharmacy service in a Spanish-speaking hospital between January 2008 and December 2012 were included. Demographics, and clinical and pharmacotherapy variables, were included in the model design. To find prognostic factors for hospital admission a multivariate logistic regression model was created after performing a univariate analysis. Model validity was determined by the shrinkage method and the model discrimination by Harrell's C-index.Results442 patients were included in the study. The variables ‘CD4 count <200 (cells/µL)’, ‘drug/alcohol use’, ‘detectable viral load (>50 copies/mL)’, ‘number of previous admissions’, and ‘number of drugs different from antiretroviral treatment’ were the independent predictors of risk of hospital admission. Probabilities predicted by the model showed an R2=0.98 for the development sample and an R2=0.86 for the validation sample. The Harrell's C index for the development and validation data were 0.82 (95% CI 0.77 to 0.87) and 0.80 (95% CI 0.73 to 0.88), respectively.ConclusionsThe model developed in this study may be useful in daily practice for identifying HIV patients at high risk of 1-year hospital admission.

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Concurrent Use of Comedications Reduces Adherence to Antiretroviral Therapy Among HIV-Infected Patients

Cited by 59 publications

References 39 publications

Analysis of self-reported adverse reactions to efavirenz and drug interactions in a population with HIV in Mexico

Analysis of self-reported adverse reactions to efavirenz and drug interactions in a population with HIV in Mexico

Medication adherence among transgender women living with HIV

Design and validation of a predictive model for 1-year hospital admission in HIV patients on antiretroviral treatment

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