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Prescribing issues among older HIV-infected persons in a Mediterranean cohort: Does the current prevalence give cause for concern?
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  • Cora Loste,
  • José Moltó,
  • Núria Pérez,
  • Jordi Puig,
  • Patricia Echeverría,
  • Anna Bonjoch,
  • Carmina R.Fumaz,
  • Begoña Lemos,
  • Carla Estany,
  • Bonaventura Clotet,
  • Eugènia Negredo
Cora Loste
Fundació Lluita Contra la Sida
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José Moltó
Fundació Lluita Contra la Sida
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Núria Pérez
Fundació Lluita Contra la Sida
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Jordi Puig
Fundació Lluita Contra la Sida
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Patricia Echeverría
Fundació Lluita Contra la Sida
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Anna Bonjoch
Fundació Lluita Contra la Sida
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Carmina R.Fumaz
Fundació Lluita Contra la Sida
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Begoña Lemos
Fundació Lluita Contra la Sida
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Carla Estany
Fundació Lluita Contra la Sida
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Bonaventura Clotet
Fundació Lluita Contra la Sida
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Eugènia Negredo
Fundació Lluita Contra la Sida
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Abstract

AIM: The main objective was to determine the prevalence of prescribing issues in HIV-infected subjects ≥65 years according to the Beers and STOPP/START criteria and drug-drug interactions (Liverpool website). Secondary objectives were to assess the concordance between Beers and STOPP/START criteria in our population, and to identify the drugs most frequently involved in the prescribing issues. METHODS: Cross-sectional cohort study based on a systematic review of the electronic drug prescriptions of 91 HIV-infected patients aged ≥65 years. Discrepancies between prescription criteria were assessed using crosstabs and compared using the Chi-square test or Fisher exact test. RESULTS: The mean age was 72.1 (5.6) years, 75.8% had ≥3 comorbidities, and 59.3% polypharmacy. Prescribing issues were identified in 87.9%; 71.4% by STOPP/START and 45.1% by Beers. Comparing both criteria, 56.9% of prescribing issues by STOPP/START were detected by Beers, while 92.5% of those detected by the Beers criteria were detected by STOPP/START (p<0.001). Orange/red flag interactions were found in 45.1%: 3 severe (red) in 2 patients (2.2%). The most frequent drugs involved in prescribing issues were benzodiazepines (>30%). Cobicistat was the drug most frequently involved in interactions (42.9%). CONCLUSIONS: The prevalence of prescribing issues among older HIV-infected persons gives cause for concern, as it is almost 90%. Optimization strategies, including a critical review of the treatment plan, should be implemented in clinical routine by a multidisciplinary team, in particular in patients with multiple comorbidities and polypharmacy. The STOPP/START criteria should be recommended for European populations, since they seem to better detect prescribing issues.

Peer review status:ACCEPTED

06 May 2020Submitted to British Journal of Clinical Pharmacology
11 May 2020Submission Checks Completed
11 May 2020Assigned to Editor
15 May 2020Reviewer(s) Assigned
31 May 2020Review(s) Completed, Editorial Evaluation Pending
09 Jun 2020Editorial Decision: Revise Major
23 Jun 20201st Revision Received
24 Jun 2020Submission Checks Completed
24 Jun 2020Assigned to Editor
24 Jun 2020Review(s) Completed, Editorial Evaluation Pending
09 Jul 2020Editorial Decision: Accept