Definitions
A prescribing issue must fulfill at least 1 criterion from the
STOPP/START and/or Beers criteria and/or be considered a drug-drug
interaction (orange or red flags).
The study was based on the latest version of the STOPP/START criteria
(2015) [14], which includes a list of medication classes divided by
sections. Briefly, the STOPP criteria cover potentially inappropriate
drugs in patients aged ≥65 years, namely, any drug prescribed without an
evidence-based clinical indication, any drug prescribed beyond the
recommended duration where treatment duration is well defined, and/or
any duplicate drug class prescription. These criteria also classify
drugs by family, such as antiplatelet/anticoagulant drugs and central
nervous system and psychotropic drugs (see supplementary data of the
reference 14). The START criteria cover vaccines and medications that
patients should take but are not prescribed. These are classified by
systems (e.g., cardiovascular and respiratory systems).
We used the 2015 version of the Beers criteria [15], which was drawn
up by an expert panel, includes a list of medications and medication
classes that should be avoided or used with caution in adults aged ≥65
years, and is divided into 5 categories.
The Liverpool University website (www.hiv-druginteractions.org) was used
to identify drug interactions with ART and concomitant medication; only
potential interactions (orange flag) and serious interactions (red flag)
were included.
Polypharmacy was defined as 5 or more concomitant drugs excluding ART.