艾滋病毒感染者多重用药的管理。

IF 1.9 4区 医学 Q4 IMMUNOLOGY
Sergio Marin, Carles Quiñones, Carla Codina Jiménez, Ester Valls, Eva Terricabras, Lidia Estrada, Glòria Cardona, Àngels Andreu
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引用次数: 2

摘要

抗逆转录病毒治疗(ART)已经改变了HIV的预后,HIV已经演变成一种慢性疾病。艾滋病毒感染者(PLWH)寿命延长,出现的合并症数量增加,导致多重用药。本文综述了有关患病率、相关因素、药物-药物相互作用(ddi)、对抗逆转录病毒治疗结果的影响、老年状况和营养状况以及旨在减少这种情况的健康干预措施的文献。自2006年以来,对MEDLINE数据库中所有相关的英语和西班牙语研究进行了文献检索。提供感兴趣数据的研究被确定并按组排序:(i)患病率和相关因素(n = 37), (ii) ddi (n = 19), (iii)对art结果的影响(n = 12), (iv)对健康状况的影响(n = 13),以及(V)评估和/或减少它的健康干预(n = 9)。多重用药发生在9-91%的PLWH中(2.6-19.5%受严重多重用药影响)。与多药相关的主要因素是年龄较大、合并症较多、虚弱、肾功能恶化和既往住院。19.15-84%的病例存在ddi(最严重类型为1.3-12.2%)。主要涉及的非art药物有抗高血压药、他汀类药物、抗血栓药、皮质类固醇、二价阳离子和抗酸药。多种药物治疗可影响ART的选择、依从性和结果,并与跌倒、虚弱和营养状况不良等一些老年疾病有关。根据stop - start和Beers标准,高达87.9%的病例存在潜在的处方问题,一些药剂师主导的干预措施已被证明可以减少处方问题。考虑到这些发现,多重用药应该被认为是这一人群的临床问题,需要优化治疗方案来减轻其负担。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The management of polypharmacy in people living with HIV.

Antiretroviral therapy (ART) has modified the prognosis of HIV which has evolved into a chronic condition. People living with HIV (PLWH) are living longer presenting an increased number of comorbidities leading to polypharmacy. Literature on the prevalence, associated factors, drug-drug interactions (DDIs), effects on ART-outcomes, geriatric conditions, and nutritional status together with health-interventions aimed to reduce it is presented in this review. A literature search was conducted on the MEDLINE database for all relevant English- and Spanish-language studies since 2006. Studies providing data of interest were identified and ordered in groups: (i) prevalence and associated factors (n = 37), (ii) DDIs (n = 19), (iii) Effects on ART-outcomes (n = 12), (iv) Effects on health conditions (n = 13), and (V) Health-interventions to assess and/or reduce it (n = 9). Polypharmacy occurs in 9-91% of PLWH (2.6-19.5% affected by severe polypharmacy). Main factors associated with polypharmacy are older age, a higher number of comorbidities, frailty, deteriorated renal function, and previous hospitalizations. DDIs were present in 19.15-84% of cases (1.3-12.2% for the most severe types). Mainly involved non-ART drugs were antihypertensives, statins, antithrombotic agents, corticosteroids, divalent cations, and antiacids. Polypharmacy can affect ART selection, adherence, and outcomes and has been related to some geriatric conditions such as falls, frailty, and poor nutritional status. Potentially prescribing issues are present in up to 87.9% of cases according to the STOPP-START and Beers criteria and some pharmacist-led interventions have been shown to reduce it. Considering these findings, polypharmacy should be considered a clinical concern in this population and treatment-optimization programs are needed to reduce its burden.

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来源期刊
AIDS reviews
AIDS reviews 医学-传染病学
CiteScore
3.40
自引率
4.50%
发文量
41
审稿时长
>12 weeks
期刊介绍: AIDS Reviews publishes papers reporting original scientific, clinical, epidemiologic and social research which contribute to the overall knowledge of the field of the acquired immunodeficiency syndrome and human retrovirology. Currently, the Journal publishes review articles (usually by invitation, but spontaneous submitted articles will also be considered). Manuscripts submitted to AIDS Reviews will be accepted on the understanding that the authors have not submitted the paper to another journal or published the material elsewhere.
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