Mohammed I Danjuma, Oyelola A Adegboye, Ahmed Aboughalia, Nada Soliman, Ruba Almishal, Haseeb Abdul, Mohamad Faisal Hamad Mohamed, Mohamed Nabil Elshafie, Abdulatif AlKhal, Abdelnaser Elzouki, Arwa Al-Saud, Mas Chaponda, Mubarak Arriyo Bidmos
{"title":"Prevalence and global trends of polypharmacy among people living with HIV: a systematic review and meta-analysis.","authors":"Mohammed I Danjuma, Oyelola A Adegboye, Ahmed Aboughalia, Nada Soliman, Ruba Almishal, Haseeb Abdul, Mohamad Faisal Hamad Mohamed, Mohamed Nabil Elshafie, Abdulatif AlKhal, Abdelnaser Elzouki, Arwa Al-Saud, Mas Chaponda, Mubarak Arriyo Bidmos","doi":"10.1177/20420986221080795","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>There has been a rising prevalence of polypharmacy among people living with HIV (PLWH). Uncertainty however remains regarding the exact estimates of polypharmacy among these cohorts of patients.</p><p><strong>Methods: </strong>We conducted a systematic search of PubMed; EMBASE, CROI, Cochrane Database of Systematic Reviews; Science Citation Index and Database of Abstracts of Reviews of Effects for studies between 1 January 2000 and 30 June 2021 that reported on the prevalence of polypharmacy (ingestion of > 5 non-ART medications) among PLWH on antiretroviral therapy regimen (ART). Prevalence of polypharmacy among HIV-positive patients on ART with Clopper-Pearson 95% confidence intervals were presented. The heterogeneity between studies was evaluated using <math> <mrow><msup><mi>I</mi> <mn>2</mn></msup> </mrow> </math> and <math> <mrow><msup><mi>τ</mi> <mn>2</mn></msup> </mrow> </math> statistics.</p><p><strong>Results: </strong>One hundred ninety-seven studies were initially identified, 23 met the inclusion criteria enrolling 55,988 PLWH, of which 76.7% [95% confidence interval (CI): 76.4-77.1] were male. The overall pooled prevalence of polypharmacy among PLWH was 33% (95% CI: 25-42%) (<i>I</i> <sup>2</sup> = 100%, τ<sup>2</sup> = 0.9170, <i>p</i> < 0.0001). Prevalence of polypharmacy is higher in the Americas (44%, 95% CI: 27-63%) (<i>I</i> <sup>2</sup> = 100%, τ<sup>2</sup> = 1.0886, <i>p</i> < 0.01) than Europe (29%, 95% CI: 20-40%) (<i>I</i> <sup>2</sup> = 100%, τ<sup>2</sup> = 0.7944, <i>p</i> < 0.01).</p><p><strong>Conclusion: </strong>The pooled prevalence estimates from this synthesis established that polypharmacy is a significant and rising problem among PLWH. The exact interventions that are likely to significantly mitigate its effect remain uncertain and will need exploration by future prospective and systematic studies.</p><p><strong>Registration: </strong><b>PROSPERO: CRD42020170071</b>.</p><p><strong>Plain language summary: </strong><b>Background:</b> In people living with HIV (PLWH), what is the prevalence of polypharmacy and is this influenced by sociodemographic factors?<b>Methods and Results:</b> In this systematic review and meta-analysis of 23 studies comprising 55,988 participants, we have for the first time found an estimated polypharmacy pooled prevalence of 33% among PLWH. There was a relatively higher pooled prevalence of polypharmacy among the America's compared with European cohorts of PLWH.<b>Conclusion:</b> Polypharmacy among PLWH is a rising morbidity that needs urgent intervention both at policy and patient levels of care.</p>","PeriodicalId":23012,"journal":{"name":"Therapeutic Advances in Drug Safety","volume":null,"pages":null},"PeriodicalIF":3.4000,"publicationDate":"2022-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/8a/fa/10.1177_20420986221080795.PMC9425890.pdf","citationCount":"4","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Therapeutic Advances in Drug Safety","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1177/20420986221080795","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2022/1/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"PHARMACOLOGY & PHARMACY","Score":null,"Total":0}
引用次数: 4
Abstract
Background: There has been a rising prevalence of polypharmacy among people living with HIV (PLWH). Uncertainty however remains regarding the exact estimates of polypharmacy among these cohorts of patients.
Methods: We conducted a systematic search of PubMed; EMBASE, CROI, Cochrane Database of Systematic Reviews; Science Citation Index and Database of Abstracts of Reviews of Effects for studies between 1 January 2000 and 30 June 2021 that reported on the prevalence of polypharmacy (ingestion of > 5 non-ART medications) among PLWH on antiretroviral therapy regimen (ART). Prevalence of polypharmacy among HIV-positive patients on ART with Clopper-Pearson 95% confidence intervals were presented. The heterogeneity between studies was evaluated using and statistics.
Results: One hundred ninety-seven studies were initially identified, 23 met the inclusion criteria enrolling 55,988 PLWH, of which 76.7% [95% confidence interval (CI): 76.4-77.1] were male. The overall pooled prevalence of polypharmacy among PLWH was 33% (95% CI: 25-42%) (I2 = 100%, τ2 = 0.9170, p < 0.0001). Prevalence of polypharmacy is higher in the Americas (44%, 95% CI: 27-63%) (I2 = 100%, τ2 = 1.0886, p < 0.01) than Europe (29%, 95% CI: 20-40%) (I2 = 100%, τ2 = 0.7944, p < 0.01).
Conclusion: The pooled prevalence estimates from this synthesis established that polypharmacy is a significant and rising problem among PLWH. The exact interventions that are likely to significantly mitigate its effect remain uncertain and will need exploration by future prospective and systematic studies.
Registration: PROSPERO: CRD42020170071.
Plain language summary: Background: In people living with HIV (PLWH), what is the prevalence of polypharmacy and is this influenced by sociodemographic factors?Methods and Results: In this systematic review and meta-analysis of 23 studies comprising 55,988 participants, we have for the first time found an estimated polypharmacy pooled prevalence of 33% among PLWH. There was a relatively higher pooled prevalence of polypharmacy among the America's compared with European cohorts of PLWH.Conclusion: Polypharmacy among PLWH is a rising morbidity that needs urgent intervention both at policy and patient levels of care.
期刊介绍:
Therapeutic Advances in Drug Safety delivers the highest quality peer-reviewed articles, reviews, and scholarly comment on pioneering efforts and innovative studies pertaining to the safe use of drugs in patients.
The journal has a strong clinical and pharmacological focus and is aimed at clinicians and researchers in drug safety, providing a forum in print and online for publishing the highest quality articles in this area. The editors welcome articles of current interest on research across all areas of drug safety, including therapeutic drug monitoring, pharmacoepidemiology, adverse drug reactions, drug interactions, pharmacokinetics, pharmacovigilance, medication/prescribing errors, risk management, ethics and regulation.