Mildmay Uganda, 12 Km Entebbe Road, Naziba Hill Lweza, P.O. Box 24985, Kampala, Uganda.
Sydney School of Public Health, Sydney Medical School, University of Sydney, Sydney, Australia.
BMC Geriatr. 2018 May 29;18(1):125. doi: 10.1186/s12877-018-0817-0.
Polypharmacy has not been investigated in patients living with HIV in developing countries. The aims of this study were to determine the prevalence of polypharmacy, the factors associated with polypharmacy and whether polypharmacy was associated with adverse effects among older adults on anti-retroviral therapy (ART).
Cross-sectional study in older adults aged 50 and over on ART attending an outpatient HIV/AIDS care centre in Uganda. Demographic and clinical data collected on number and type of medications plus supplements, possible medication related side-effects, comorbidity, frailty, cognitive impairment, current CD4 count and viral load.
Of 411 participants, 63 (15.3, 95% C.I. 11.9, 18.8) had polypharmacy (≥ 4 non- HIV medications). In multivariate analyses, polypharmacy was associated with one or more hospitalisations in the last year (Prevalence Ratio PR = 1.8, 95% C.I. 1.1, 3.1, p = 0.02), prescription by an internist (PR = 3.6, 95% C.I. 1.3, 10.5, p = 0.02) and frailty index scores of 5 to 6 (PR = 10.6, 95% C.I. 1.4, 78, p = 0.02), and 7 or more (PR = 17.4, 95% C.I. 2.4, 126.5, p = 0.005). Polypharmacy was not associated with frequency and severity of possible medication related side effects and falls.
Polypharmacy is common among older HIV infected patients in sub-Saharan Africa. It's more prevalent among frail people, who have been in hospital in the last year and who have been seen by an internist. We found no evidence that polypharmacy results in any harm but this is worth exploring further.
在发展中国家，针对感染艾滋病毒的患者，尚未对其药物的使用情况进行研究。本研究旨在确定老年人接受抗逆转录病毒治疗（ART）时药物使用的普遍性，影响药物使用的因素，以及药物使用是否与不良反应有关。
在乌干达的一个艾滋病门诊护理中心，对年龄在 50 岁及以上的接受 ART 的老年人进行了一项横断面研究。收集了人口统计学和临床数据，包括药物和补充剂的数量和类型、可能与药物相关的副作用、合并症、虚弱、认知障碍、当前 CD4 计数和病毒载量。
在 411 名参与者中，有 63 名（15.3%，95%置信区间为 11.9%，18.8%）存在药物使用过量（≥4 种非 HIV 药物）。多变量分析显示，药物使用过量与过去一年中一次或多次住院（优势比[PR]为 1.8，95%置信区间为 1.1，3.1，p=0.02）、由内科医生开具处方（PR 为 3.6，95%置信区间为 1.3，10.5，p=0.02）和衰弱指数评分为 5-6 分（PR 为 10.6，95%置信区间为 1.4，78，p=0.02）以及 7 分或更高（PR 为 17.4，95%置信区间为 2.4，126.5，p=0.005）相关。药物使用过量与可能与药物相关的副作用的发生频率和严重程度以及跌倒无关。
在撒哈拉以南非洲，感染艾滋病毒的老年患者中，药物使用过量很常见。在过去一年中住院过的虚弱人群和接受过内科医生治疗的人群中，这种情况更为普遍。我们没有发现药物使用过量会导致任何伤害的证据，但值得进一步探讨。
