Drug burden index in people living with HIV over 50 years of age in a real clinical practice cohort

IF 2.6 4区医学 Q3 INFECTIOUS DISEASES

Enfermedades infecciosas y microbiologia clinica Pub Date : 2024-08-01 DOI:10.1016/j.eimc.2023.04.010

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引用次数: 0

Abstract

Objectives

To determine DBI and its relationship with polypharmacy and pharmacotherapeutic complexity (PC) in a cohort of PLWH over 50 years of age at follow-up of pharmacotherapy in a tertiary hospital.

Methods

Observational and retrospective study that included PLWH in active antiretroviral treatment over 50 years of age who have been followed up in outpatient pharmacy services. Pharmacotherapeutic complexity was estimated through Medication Regimen Complexity Index (MRCI). Collected variables included comorbidities, current prescriptions and its classification according to anticholinergic and sedative activity and associated risk of falls.

Results

Studied population included 251 patients (85.7% men; median age: 58 years, interquartile range: 54–61). There was a high prevalence of high DBI scores (49.2%). High DBI was significantly correlated with a high PC, polypharmacy, psychiatric comorbidity and substances abuse (p < 0.05). Among sedative drugs, the most prescribed were anxiolytic drugs (N05B) (n = 85), antidepressant drugs (N06A) (n = 41) and antiepileptic drugs (N03A) (n = 29). For anticholinergic drugs, alpha-adrenergic antagonist drugs (G04C) were the most prescribed (n = 18). Most frequent drugs associated with risk of falls were anxiolytics (N05B) (n = 85), angiotensin-converting enzyme inhibitors (C09A) (n = 61) and antidepressants (N06A) (n = 41).

Conclusion

The DBI score in older PLWH is high and it is related to PC, polypharmacy, mental diseases and substance abuse as is the prevalence of fall-related drugs. Control of these parameters as well as the reduction of the sedative and anticholinergic load should be included in the lines of work in the pharmaceutical care of people living with HIV+.

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真实临床实践队列中 50 岁以上艾滋病毒感染者的药物负担指数

方法观察性和回顾性研究纳入了在门诊药房接受随访的 50 岁以上接受积极抗逆转录病毒治疗的 PLWH。通过用药方案复杂性指数（MRCI）估算药物治疗的复杂性。收集的变量包括合并症、当前处方及其根据抗胆碱能药物和镇静剂活性进行的分类以及相关的跌倒风险。高 DBI 评分的发生率很高（49.2%）。高 DBI 与高 PC、多重用药、精神疾病合并症和药物滥用有明显相关性（p < 0.05）。在镇静药中，处方最多的是抗焦虑药（N05B）（85 人）、抗抑郁药（N06A）（41 人）和抗癫痫药（N03A）（29 人）。在抗胆碱能药物中，α-肾上腺素能拮抗剂（G04C）是处方量最大的药物（18 人）。与跌倒风险相关的最常见药物是抗焦虑药（N05B）（n = 85）、血管紧张素转换酶抑制剂（C09A）（n = 61）和抗抑郁药（N06A）（n = 41）。控制这些参数以及减少镇静剂和抗胆碱能药物的用量应纳入艾滋病毒感染者药物治疗的工作范围。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Enfermedades infecciosas y microbiologia clinica 医学-传染病学

CiteScore

2.10

自引率

8.00%

发文量

194

审稿时长

29 days

期刊介绍： Hoy está universalmente reconocida la renovada y creciente importancia de la patología infecciosa: aparición de nuevos agentes patógenos, de cepas resistentes, de procesos con expresión clínica hasta ahora desconocida, de cuadros de una gran complejidad. Paralelamente, la Microbiología y la Infectología Clínicas han experimentado un gran desarrollo como respuesta al reto planteado por la actual patología infecciosa. Enfermedades Infecciosas y Microbiología Clínica es la Publicación Oficial de la Sociedad Española SEIMC. Cumple con la garantía científica de esta Sociedad, la doble función de difundir trabajos de investigación, tanto clínicos como microbiológicos, referidos a la patología infecciosa, y contribuye a la formación continuada de los interesados en aquella patología mediante artículos orientados a ese fin y elaborados por autores de la mayor calificación invitados por la revista.