Bastida Carla, Grau Ana, Márquez Mònica, Tuset Montse, De Lazzari Elisa, Martínez Esteban, Gatell Josep Maria
Pharmacy Service, Hospital Clínic, Barcelona..
Infectious Diseases Service, Hospital Clínic, Barcelona..
Farm Hosp. 2017 Sep 1;41(5):618-624. doi: 10.7399/fh.10778.
Comorbidities associated with the ageing of the HIV+ population may require chronic treatment. Our aim is to determine the degree of polypharmacy and the number of potential drug-drug interactions, as well as the relationship between both variables in a HIV-infected population over the age of 65.
Descriptive transversal study targeting HIV+ patients aged ≥65, attended in a Spanish hospital in 2014. The prevalence of polypharmacy (≥5 drugs) and potential drug-drug interactions were assessed, and also risk factors associated with such.
265 subjects aged ≥65 years were identified, 197 of whom were on antiretroviral treatment and had data about their electronic prescription. 93% were polymedicated. The patients whose antiretroviral treatment included a non-nucleoside reverse transcriptase inhibitor (NNRTI) demonstrated a fourfold probability of being polymedicated. 65% of the patients showed at least one potential drug-drug interaction and 6.6% a severe potential drug-drug interaction. The risk of interaction was significantly associated with the number of prescribed drugs (incidence rate ratio per prescribed drug, CI 95%: 1.18 (1.14;1.22; p<0.0001) and with the use of protease inhibitors (PI) (incidence rate ratio, CI 95%: 1.65 (1.28;2.11; p=0.0001)).
Polypharmacy has a high prevalence and is more common in patients treated with NNRTI. The number of potential drug-drug interactions increase with the number of prescribed drugs and is higher in those patients on PI.
与HIV阳性人群老龄化相关的合并症可能需要长期治疗。我们的目的是确定多重用药的程度和潜在药物相互作用的数量，以及65岁以上HIV感染人群中这两个变量之间的关系。
2014年在一家西班牙医院对年龄≥65岁的HIV阳性患者进行描述性横断面研究。评估多重用药（≥5种药物）和潜在药物相互作用的患病率，以及与之相关的危险因素。
确定了265名年龄≥65岁的受试者，其中197人接受抗逆转录病毒治疗并拥有电子处方数据。93%的患者存在多重用药情况。抗逆转录病毒治疗中包含非核苷类逆转录酶抑制剂（NNRTI）的患者多重用药的可能性是其他人的四倍。65%的患者至少存在一种潜在药物相互作用，6.6%的患者存在严重潜在药物相互作用。相互作用的风险与所开药物的数量显著相关（每种所开药物的发病率比，95%置信区间：1.18（1.14；1.22；p<0.0001）），也与蛋白酶抑制剂（PI）的使用有关（发病率比，95%置信区间：1.65（1.28；2.11；p=0.0001））。
多重用药的患病率很高，在接受NNRTI治疗的患者中更为常见。潜在药物相互作用的数量随所开药物数量的增加而增加，在使用PI的患者中更高。
