Chibi Buyisile, Yende-Zuma Nonhlanhla, Mashamba-Thompson Tivani P
Discipline of Public Health Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa.
Centre for the AIDS Programme of Research in South Africa, Doris Duke Medical Research Institute, Durban, South Africa.
PLoS One. 2020 Dec 16;15(12):e0243718. doi: 10.1371/journal.pone.0243718. eCollection 2020.
Prescription drug diversion, and misuse has increased over the past decade and is notably in high-income-countries and significantly contributes to the opioid epidemic. People living with HIV (PLWH) are particularly vulnerable to prescription drug diversion, and misuse as most experience chronic pain, mental health problems and HIV-related illnesses. The researchers investigated the prevalence and correlates of prescription drug diversion, and misuse among PLWH in the eThekwini district, KwaZulu-Natal.
A cross-sectional study was conducted among 392 PLWH, conveniently recruited from the public healthcare facilities located in rural, semi-urban and urban areas of the eThekwini district. Participants answered questions about their background, prescription medications, substance use, and prescription drug diversion, and misuse. Descriptive analysis was performed to estimate the prevalence of prescription drug diversion, and misuse. Multivariable logistic regression was used to identify predictors of prescription drug diversion, and misuse.
Overall, 13% of the participants reported lifetime prescription drug diversion. The most common type of diversion was using prescription medication not prescribed by a healthcare provider (11%), followed by sharing of prescription medication (9%) and buying prescription medication without a medical script (5%). Twenty-three per cent of the participants reported prescription drug misuse in the past 90 days, with using prescription medication without a healthcare providers' guidance (9%) and not following the scheduled time periods (8%) being the most common reported types of misuse. Self-medicating was identified as a risk factor for prescription drug misuse. There was no association between ART adherence and prescription drug diversion, and misuse.
The study findings contribute to improving the limited data available on prescription drug diversion, and misuse among PLWH in South Africa. The prevalence underscores a need for urgent interventions when prescribing medications with potential risks. Addressing the risk of self-medicating is imperative for HIV care outcomes and to avert death.
在过去十年中，处方药的转移和滥用现象有所增加，在高收入国家尤为明显，并且是阿片类药物流行的重要原因。艾滋病毒感染者（PLWH）特别容易发生处方药转移和滥用，因为大多数人都经历过慢性疼痛、心理健康问题和与艾滋病毒相关的疾病。研究人员调查了夸祖鲁 - 纳塔尔省伊代昆尼区艾滋病毒感染者中处方药转移和滥用的患病率及其相关因素。
对392名艾滋病毒感染者进行了一项横断面研究，这些感染者是从伊代昆尼区农村、半城市和城市地区的公共医疗设施中方便抽样招募的。参与者回答了有关他们的背景、处方药、物质使用以及处方药转移和滥用的问题。进行描述性分析以估计处方药转移和滥用的患病率。使用多变量逻辑回归来确定处方药转移和滥用的预测因素。
总体而言，13%的参与者报告有终生处方药转移行为。最常见的转移类型是使用医疗保健提供者未开的处方药（11%），其次是分享处方药（9%）和无医疗处方购买处方药（5%）。23%的参与者报告在过去90天内有处方药滥用行为，最常见的滥用类型是在没有医疗保健提供者指导的情况下使用处方药（9%）和不遵守规定的服药时间（8%）。自我用药被确定为处方药滥用的一个风险因素。抗逆转录病毒治疗依从性与处方药转移和滥用之间没有关联。
该研究结果有助于改善南非艾滋病毒感染者中有关处方药转移和滥用的有限数据。这一患病率凸显了在开具具有潜在风险的药物时进行紧急干预的必要性。解决自我用药的风险对于艾滋病毒护理结果和避免死亡至关重要。
