Polypharmacy among patients attending an AIDS clinic: utilization of prescribed, unorthodox, and investigational treatments.
The objective of this study was to describe the utilization and characteristics associated with the use of prescribed, over-the-counter, investigational, and unorthodox treatments among AIDS clinic patients. This report is derived from cross-sectional data obtained using structured telephone surveys. Study participants (n = 197) were recruited from the University of California, San Francisco, Medical Center AIDS clinic. One hundred eighty-nine participants (96%) received 1-24 prescription medications during the 3 months prior to interview. Those with an AIDS diagnosis received a relatively greater number of prescription drugs (p = 0.0001); an average of 5.6 prescribed medications were used by AIDS patients versus 4.8 among AIDS-related complex and 2.3 among asymptomatic patients. Thirty-one percent participated in drug trials during the 3 months before interview, including 18% who were in multiple studies. Twenty-nine percent used unorthodox treatments. Seventy-five (40%) received prescription medication from a provider other than their primary provider. A more advanced stage of illness was associated with the use of unorthodox treatments (p = 0.003): users of these treatments had a greater educational attainment than nonusers (p = 0.03) and were significantly less likely to report that their primary provider was aware of all the treatments they used (odds ratio = 2.1, p less than 0.03). We conclude that use of polypharmacy among some AIDS clinic patients is common, could create an increased risk for adverse drug reactions, and may affect clinical drug trials. Despite having decided to obtain care at a university-based clinic, many of the participants of this study also chose to receive unorthodox therapies and care from nonprimary medical providers.(ABSTRACT TRUNCATED AT 250 WORDS)
Greenblatt
R M
RM
Department of Medicine, University of California, School of Medicine, San Francisco.
Hollander
H
H
McMaster
J R
JR
Henke
C J
CJ
D000386:AIDS-Related Complex / Q000188:drug therapy; D000163:Acquired Immunodeficiency Syndrome / Q000188:drug therapy*; D000328:Adult; D000554:Ambulatory Care Facilities; D002986:Clinical Trials as Topic; D000529:Complementary Therapies; D011307:Drug Prescriptions; D004359:Drug Therapy, Combination; D015507:Drugs, Investigational / Q000627:therapeutic use; D005260:Female; D006801:Humans; D013287:Illicit Drugs; D008297:Male; D004366:Nonprescription Drugs / Q000627:therapeutic use
D015507:Drugs, Investigational; D013287:Illicit Drugs; D004366:Nonprescription Drugs