Pharmacy Department, Hospital Clínico Universitario Lozano Blesa, C/San Juan Bosco, Zaragoza, Spain.
Aragon Institute for Health Research, Zaragoza, Spain.
Int J Clin Pharm. 2021 Oct;43(5):1245-1250. doi: 10.1007/s11096-021-01242-1. Epub 2021 Feb 4.
The prolonged current survival of human immunodeficiency virus (HIV) patients exposes them to new problems arising from the comorbidities they face.
To describe the situation of comorbidities, polypharmacy, therapeutic complexity and adherence in people living with HIV over 65 years of age and to assess the presence of potentially inappropriate prescriptions (PIP) by applying deprescription criteria.
Observational study including HIV people (> 65 years) from a university tertiary level hospital. Demographic, clinical and pharmacotherapeutic characteristics of the patients and their treatments were studied. The prevalence of polypharmacy (> 5 medications) and the pharmacotherapy complexity, quantified by the Medication Regimen Complexity Index (MRCI), were calculated. Therapeutic adherence was assessed by the Simplified Medication Adherence Questionnaire (SMAQ) and the medication possession ratio, according to prescription dispensing records. The Screening Tool of Older People's Prescriptions (STOPP) and List of Evidence-baSed depreScribing for CHRONic patients (LESS-CHRON) criteria were applied to identify PIP.
PIP in elderly people living with HIV.
Thirty patients were included, 73% of whom were men, with a median age of 71 years (IQR 67 - 76) and a median duration of infection of 17 years (IQR, 9 - 21). Seventy percent of the patients suffered from dyslipemia, 66.7% from hypertension, 43.3% from diabetes and 26.7% from mental health disorders. Seventy percent of the patients took more than 5 medications and 30% more than 10. The MRCI of concomitant medications was higher (18.3 points) than the MRCI of antiretroviral therapy (5.1 points), 66.7% of the studied population was classified as adherent. Finally, 70% of the patients present some PIP according to the STOPP or LESS-CHRON criteria. The polypharmacy was significantly associated (p = 0.008) with meeting deprescription criteria.
The elderly people living with HIV present numerous comorbidities and met the criteria for polypharmacy. Their pharmacotherapy complexity is mainly determined by the concomitant treatments. There is a high prevalence of meeting deprescription criteria in people living with HIV over the age of 65 and a clear relationship between polypharmacy and deprescription. The optimization of pharmacotherapy is necessary in this population.
人类免疫缺陷病毒（HIV）患者的存活时间延长，使他们面临新的问题，这些问题源于他们所面临的合并症。
描述 65 岁以上 HIV 感染者的合并症、多种药物治疗、治疗复杂性和治疗依从性的情况，并应用停药标准评估潜在不适当处方（PIP）的存在。
这是一项包括来自大学三级医院的 HIV 感染者（>65 岁）的观察性研究。研究了患者的人口统计学、临床和药物治疗特征及其治疗情况。计算了多种药物治疗（>5 种药物）和药物治疗复杂性（通过药物治疗方案复杂性指数（MRCI）量化）的患病率。通过简化用药依从性问卷（SMAQ）和根据处方配药记录评估药物持有率来评估治疗依从性。应用老年人用药筛查工具（STOPP）和基于证据的慢性患者停药清单（LESS-CHRON）标准来识别 PIP。
老年 HIV 感染者的 PIP。
共纳入 30 名患者，其中 73%为男性，中位年龄为 71 岁（IQR 6776），中位感染时间为 17 年（IQR 921）。70%的患者患有血脂异常，66.7%的患者患有高血压，43.3%的患者患有糖尿病，26.7%的患者患有精神健康障碍。70%的患者服用了 5 种以上药物，30%的患者服用了 10 种以上药物。同时服用的药物的 MRCI 较高（18.3 分），而抗逆转录病毒治疗的 MRCI 较低（5.1 分），66.7%的研究人群被归类为依从性较好。最后，根据 STOPP 或 LESS-CHRON 标准，70%的患者存在一些 PIP。多药治疗与符合停药标准显著相关（p=0.008）。
老年 HIV 感染者存在多种合并症，并符合多种药物治疗标准。他们的药物治疗复杂性主要由伴随治疗决定。65 岁以上 HIV 感染者中符合停药标准的比例较高，且多药治疗与停药之间存在明显关系。在这一人群中，有必要优化药物治疗。
