Prevalence of concomitant medications in older HIV+ patients and comparison with general population

Gimeno-Gracia, Mercedes; Crusells-Canales, María José; Armesto-Gómez, Francisco Javier; Rabanaque, María José

doi:10.1179/1528433614z.0000000012

Cited by 29 publications

(43 citation statements)

References 21 publications

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“…The differences were statistically significant for males but not for females; this was probably because females were underrepresented in this HIV population. The findings of this study were consistent with previous findings by our group, which showed no differences between the percentage of HIV-positive males and males from the general population receiving cardiovascular drugs such as renin–angiotensin inhibitors or lipid-lowering drugs 23. In the present study, there were no differences in cardiovascular drug use between the two populations compared, independently of sex.…”

Section: Discussionsupporting

confidence: 93%

“…The proportion of HIV-positive patients who collected five or more non-ART medications in our study is slightly lower than previously reported rates (43.8% and 47.2% for males and females, respectively, in our study compared with 54.0% and 57.6% for both sexes in other studies) 17,23. This difference could be due to the fact that, unlike other studies, we did not include alternative treatments.…”

Section: Discussioncontrasting

confidence: 90%

“…Our study published in 201523 also compared concomitant medication usage between HIV-positive individuals and the general population, but the present study adds several aspects to this. This study has a larger number of HIV-positive patients, increased from 130 in 2011 to 199 in 2014.…”

Section: Discussionmentioning

confidence: 99%

“…A previous study by our team in 2011 analyzed non-ART medication in the HIV-positive population aged ≥50 years, and compared this with the findings in the general population 23. Medications were analyzed at the second level of the World Health Organization (WHO) Anatomical Therapeutic Chemical (ATC) classification, and only male patients were compared.…”

Section: Introductionmentioning

confidence: 99%

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Polypharmacy in older adults with human immunodeficiency virus infection compared with the general population

Gimeno-Gracia¹,

Crusells-Canales²,

Armesto-Gómez³

et al. 2016

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BackgroundThe percentage of older HIV-positive patients is growing, with an increase in age-related comorbidities and concomitant medication.ObjectivesTo quantify polypharmacy and profile types of non-antiretroviral drugs collected at community pharmacies in 2014 by HIV-positive individuals on antiretroviral therapy and to compare these findings with those of the general population.MethodsHIV-positive patients (n=199) were compared with a group of patients from the general population (n=8,172), aged between 50 and 64 years. The factors compared were prevalence of polypharmacy (≥5 comedications with cumulative defined daily dose [DDD] per drug over 180), percentage of patients who collected each therapeutic class of drug, and median duration for each drug class (based on DDD). Results were stratified by sex.ResultsPolypharmacy was more common in HIV-positive males than in the male general population (8.9% vs 4.4%, P=0.010). Polypharmacy was also higher in HIV-positive females than in the female general population (11.3% vs 3.4%, P=0.002). Percentage of HIV-positive patients receiving analgesics, anti-infectives, gastrointestinal drugs, central nervous system (CNS) agents, and respiratory drugs was higher than in the general population, with significant differences between male populations. No differences were observed in proportion of patients receiving cardiovascular drugs. The estimated number of treatment days (median DDDs) were higher in HIV-positive males than in males from the general population for anti-infectives (32.2 vs 20.0, P<0.001) and CNS agents (238.7 vs 120.0, P=0.002). A higher percentage of HIV-positive males than males from the general population received sulfonamides (17.1% vs 1.5%, P<0.001), macrolides (37.1% vs 24.9%, P=0.020), and quinolones (34.3% vs 21.2%, P=0.009).ConclusionPolypharmacy is more common in HIV-positive older males and females than in similarly aged members of the general population. HIV-positive patients received more CNS drugs and anti-infectives, specifically sulfonamides, macrolides, and quinolones, but there were no differences in the percentage of patients receiving cardiovascular drugs. It is essential to investigate nonantiretroviral therapy medication use in the HIV-positive population to ensure these patients receive appropriate management.

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Section: Discussionsupporting

confidence: 93%

Section: Discussioncontrasting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Polypharmacy in older adults with human immunodeficiency virus infection compared with the general population

Gimeno-Gracia¹,

Crusells-Canales²,

Armesto-Gómez³

et al. 2016

CIA

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“…70,[120][121][122][123] The clinician must face the challenge of selecting an appropriate HAART regimen in a na€ ıve HIV-infected elderly patient and to adapt an ongoing HAART according to concurrent medications in an aging patients already receiving antiretrovirals. Table 2 illustrate a brief summary of the most relevant interactions between first-line antiretrovirals and commonly prescribed drugs in the aging population.…”

Section: Drug-drug Interactionsmentioning

confidence: 99%

Immunosenescence and hurdles in the clinical management of older HIV-patients

2017

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People living with HIV (PLWH) who are treated with effective highly active antiretroviral therapy (HAART) have a similar life expectancy to the general population. Moreover, an increasing proportion of new HIV diagnoses are made in people older than 50 y. The number of older HIVinfected patients is thus constantly growing and it is expected that by 2030 around 70% of PLWH will be more than 50 y old. On the other hand, HIV infection itself is responsible for accelerated immunosenescence, a progressive decline of immune system function in both the adaptive and the innate arm, which impairs the ability of an individual to respond to infections and to give rise to long-term immunity; furthermore, older patients tend to have a worse immunological response to HAART.In this review we focus on the pathogenesis of HIV-induced immunosenescence and on the clinical management of older HIV-infected patients.

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A Pharmacist‐Led Program to Evaluate and Reduce Polypharmacy and Potentially Inappropriate Prescribing in Older HIV‐Positive Patients

et al. 2017

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Prevalence of concomitant medications in older HIV+ patients and comparison with general population

Abstract: Older HIV-positive patients frequently take a higher number of co-medication, which increases the risk of adverse events, interactions with other medication, and may lead to poorer treatment adherence.

Cited by 29 publications

References 21 publications

Polypharmacy in older adults with human immunodeficiency virus infection compared with the general population

Polypharmacy in older adults with human immunodeficiency virus infection compared with the general population

Immunosenescence and hurdles in the clinical management of older HIV-patients

A Pharmacist‐Led Program to Evaluate and Reduce Polypharmacy and Potentially Inappropriate Prescribing in Older HIV‐Positive Patients

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