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.