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...

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Publicado en:AIDS Reviews Vol. 25; no. 1; pp. 27 - 41
Autores principales: Marin, Sergio, Quiñones, Carles, Jiménez, Carla Codina, Valls, Ester, Terricabras, Eva, Estrada, Lidia, Cardona, Glòria, Andreu, Àngels
Formato: Artículo
Publicado: Publicidad Permanyer SLU Jan-Mar2023
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Jan-Mar2023
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        10.24875/AIDSRev.M23000059
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          Marin, Sergio
          Quiñones, Carles
          Jiménez, Carla Codina
          Valls, Ester
          Terricabras, Eva
          Estrada, Lidia
          Cardona, Glòria
          Andreu, Àngels
        affil: Department of Pharmacy, Hospital Universitari Germans Trias i Pujol, Badalona, Spain
      sug:
      keyword:
        Aging
        Antiretroviral agents
        Drug interactions
        HIV
        Malnutrition
        Polypharmacy
        Sarcopenia
        Treatment adherence and compliance
        Treatment outcome
      ab: 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 STOPPSTART 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.
      pubtype: Academic Journal
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    language: English
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      custom: Copyright of AIDS Reviews is the property of Publicidad Permanyer SLU and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use.
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