Potential prescribing issues among older HIV-infected subjects in a Mediterranean cohort: Does the current prevalence give cause for concern?


Journal

British journal of clinical pharmacology
ISSN: 1365-2125
Titre abrégé: Br J Clin Pharmacol
Pays: England
ID NLM: 7503323

Informations de publication

Date de publication:
03 2021
Historique:
received: 09 05 2020
revised: 23 06 2020
accepted: 09 07 2020
pubmed: 28 8 2020
medline: 27 7 2021
entrez: 28 8 2020
Statut: ppublish

Résumé

To determine the prevalence of potential prescribing issues (PPI) in HIV-infected subjects aged ≥65 years according to the Beers and STOPP/START criteria and antiretroviral drug-drug interactions (Liverpool website). Secondary objectives were to assess the concordance between Beers and STOPP/START criteria in our population, and to identify the drugs most frequently involved in PPI. Cross-sectional cohort study based on a systematic review of the electronic drug prescriptions confirmed by an interview of 91 HIV-infected patients aged ≥65 years. Discrepancies between prescription criteria were assessed using crosstabs and compared using the χ The mean age was 72.1 (5.6) years, 75.8% had ≥3 comorbidities and 59.3% polypharmacy. PPI were identified in 87.9%: 71.4% by STOPP/START and 45.1% by Beers. Comparing both criteria, 56.9% of PPI by STOPP/START were detected by Beers, while 92.5% of those detected by the Beers criteria were detected by STOPP/START (P < .001). Amber/red flag interactions between antiretrovirals and comedications were found in 45.1%: 3 severe (red) in 2 patients (2.2%). The most frequent drugs involved in PPI were benzodiazepines (>30%). Cobicistat was the drug most frequently involved in potential interactions (42.2%). The prevalence of PPI among older HIV-infected persons gives cause for concern, as it is almost 90%. Optimization strategies, including a critical review of the treatment plan, should be implemented in clinical routine by a multidisciplinary team, in particular in patients with multiple comorbidities and polypharmacy. The STOPP/START criteria seem to detect more PPI, mainly for European populations.

Identifiants

pubmed: 32852102
doi: 10.1111/bcp.14513
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

1310-1317

Informations de copyright

© 2020 The British Pharmacological Society.

Références

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Auteurs

Cora Loste (C)

Infectious Diseases Department & Lluita contra la Sida Foundation, Hospital Universitari Germans Trias i Pujol, Badalona; Universitat Autònoma de Barcelona, Spain.
Chair in Infectious Diseases and Immunity, Centre for Health and Social Care Research (CESS), Faculty of Medicine, University of Vic - Central University of Catalonia (UVic - UCC), Spain.

José Moltó (J)

Infectious Diseases Department & Lluita contra la Sida Foundation, Hospital Universitari Germans Trias i Pujol, Badalona; Universitat Autònoma de Barcelona, Spain.

Núria Pérez-Álvarez (N)

Infectious Diseases Department & Lluita contra la Sida Foundation, Hospital Universitari Germans Trias i Pujol, Badalona; Universitat Autònoma de Barcelona, Spain.
Department of Statistics and Operations Research, Technical University of Catalonia-Barcelona Tech, Barcelona, Spain.

Jordi Puig (J)

Infectious Diseases Department & Lluita contra la Sida Foundation, Hospital Universitari Germans Trias i Pujol, Badalona; Universitat Autònoma de Barcelona, Spain.

Patricia Echeverría (P)

Infectious Diseases Department & Lluita contra la Sida Foundation, Hospital Universitari Germans Trias i Pujol, Badalona; Universitat Autònoma de Barcelona, Spain.

Anna Bonjoch (A)

Infectious Diseases Department & Lluita contra la Sida Foundation, Hospital Universitari Germans Trias i Pujol, Badalona; Universitat Autònoma de Barcelona, Spain.

Carmina R Fumaz (CR)

Infectious Diseases Department & Lluita contra la Sida Foundation, Hospital Universitari Germans Trias i Pujol, Badalona; Universitat Autònoma de Barcelona, Spain.

Begoña Lemos (B)

Infectious Diseases Department & Lluita contra la Sida Foundation, Hospital Universitari Germans Trias i Pujol, Badalona; Universitat Autònoma de Barcelona, Spain.

Carla Estany (C)

Infectious Diseases Department & Lluita contra la Sida Foundation, Hospital Universitari Germans Trias i Pujol, Badalona; Universitat Autònoma de Barcelona, Spain.

Bonaventura Clotet (B)

Infectious Diseases Department & Lluita contra la Sida Foundation, Hospital Universitari Germans Trias i Pujol, Badalona; Universitat Autònoma de Barcelona, Spain.
Chair in Infectious Diseases and Immunity, Centre for Health and Social Care Research (CESS), Faculty of Medicine, University of Vic - Central University of Catalonia (UVic - UCC), Spain.
AIDS Research Institute-IRSICAIXA, Hospital Universitari Germans Trias i Pujol, Badalona; Universitat Autònoma de Barcelona, Spain.

Eugenia Negredo (E)

Infectious Diseases Department & Lluita contra la Sida Foundation, Hospital Universitari Germans Trias i Pujol, Badalona; Universitat Autònoma de Barcelona, Spain.
Chair in Infectious Diseases and Immunity, Centre for Health and Social Care Research (CESS), Faculty of Medicine, University of Vic - Central University of Catalonia (UVic - UCC), Spain.

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