Potentially inappropriate medications in older adults living with HIV

Lopez-Centeno, B, Badenes-Olmedo, C, Mataix-Sanjuan, A, Bellon, JM, Perez-Latorre, L, Lopez, JC, Benedi, J, Khoo, S ORCID: 0000-0002-2769-0967, Marzolini, C, Calvo-Alcantara, MJ
et al (show 1 more authors) (2020) Potentially inappropriate medications in older adults living with HIV. HIV MEDICINE, 21 (8). pp. 541-546.

[img] Text
PIMs & HIV MS v09.docx - Author Accepted Manuscript

Download (82kB)


<h4>Objectives</h4>We assessed the prevalence of potentially inappropriate medication (PIM) among older (≥ 65 years) people living with HIV (O-PLWH) in the region of Madrid.<h4>Methods</h4>We analysed the dispensation registry of community and hospital pharmacies from the Madrid Regional Health Service (SERMAS) for the period between 1 January and 30 June 2017, looking specifically at PIMs according to the 2019 Beers criteria. Co-medications were classified according to the Anatomical Therapeutic Chemical (ATC) classification system.<h4>Results</h4>A total of 6 636 451 individuals received medications. Of these individuals, 22 945 received antiretrovirals (ARVs), and of these 1292 were O-PLWH. Overall, 1135 (87.8%) O-PLWH were taking at least one co-medication, and polypharmacy (at least five co-medications) was observed in 852 individuals (65.9%). A PIM was identified in 482 (37.3%) O-PLWH. Factors independently associated with PIM were polypharmacy [adjusted odds ratio (aOR) 7.08; 95% confidence interval (CI) 5.16-9.72] and female sex (aOR 1.75; 95% CI 1.30-2.35). The distribution of PIMs according to ATC drug class were nervous system drugs (n = 369; 28.6%), musculoskeletal system drugs (n = 140; 10.8%), gastrointestinal and metabolism drugs (n = 72; 5.6%), cardiovascular drugs (n = 61; 4.7%), respiratory system drugs (n = 13; 1.0%), antineoplastic and immunomodulating drugs (n = 10; 0.8%), and systemic anti-infectives (n = 2; 0.2%). Five drugs accounted for 84.8% of the 482O PLWH with PIMs: lorazepam (38.2%), ibuprofen (18.0%), diazepam (10.2%), metoclopramide (9.9%), and zolpidem (8.5%).<h4>Conclusions</h4>Prescription of PIMs is highly prevalent in O-PLWH. Consistent with data in uninfected elderly people, the most frequently observed PIMs were benzodiazepines and nonsteroidal anti-inflammatory drugs . Targeted interventions are warranted to reduce inappropriate prescribing and polypharmacy in this vulnerable population.

Item Type: Article
Uncontrolled Keywords: aging, antiretroviral drugs, HIV, polypharmacy, potentially inappropriate medication
Divisions: Faculty of Health and Life Sciences
Faculty of Health and Life Sciences > Institute of Systems, Molecular and Integrative Biology
Depositing User: Symplectic Admin
Date Deposited: 17 Nov 2021 09:49
Last Modified: 18 Jan 2023 21:24
DOI: 10.1111/hiv.12883
Related URLs:
URI: https://livrepository.liverpool.ac.uk/id/eprint/3143286