Potentially Inappropriate Medication and Associated Factors Among Older Patients with HIV/AIDS: A Multicenter Cross-Sectional Study.

Abstract

Purpose: This study sought to characterize the prevalence, patterns, and associated risk factors for Potentially Inappropriate Medication use among older patients living with HIV/AIDS. The ultimate goal of this study is to inform strategies to increase medication safety in this vulnerable population.

Patients and methods: Using the 2023 American Geriatrics Society Beers Criteria, we performed a comprehensive retrospective analysis of medication use patterns among HIV/AIDS patients aged ≥65 years, drawing data from 21 hospitals across eight Chinese cities between 2019 and 2023. The analytical framework incorporated descriptive statistics, negative binomial regression for trend analysis, and multivariable logistic regression to evaluate PIM prevalence and identify associated risk factors.

Results: The analysis included 2,642 patients (80.28% male; median age 71 years, IQR: 67~75). The PIM prevalence was 23.20% (613/2,642) in the cohort, with medications contraindicated in older adults constituting the largest category (51.87%), followed by disease-related PIMs (19.88%) and medications requiring cautious use (27.80%). Type 3 PIMs demonstrated a consistent and statistically significant downward trend throughout the study period (P<0.001). Conversely, using a single PIM exhibited a statistically significant upward trajectory (P=0.020). In multivariate modeling, polypharmacy emerged as the strongest predictor of PIM use (adjusted OR=9.05, 95% CI: 7.20~11.38), followed by hospitalization (adjusted OR=1.38, 95% CI: 1.05~1.80), with consistent associations observed across the 65~84 year age range (all P<0.05).

Conclusion: The substantial and increasing burden of PIM use among elderly patients living with HIV/AIDS underscores the urgent need for enhanced medication oversight. Targeted intervention strategies should prioritize patients with polypharmacy, those requiring hospitalization, and those with specific age demographics.