title: An observational study of comorbidity and healthcare utilisation among HIV-positive patients aged 50 years and over.
abstract: The number of HIV-positive people aged ≥50 years is rising each year. We measured the prevalence of non-infectious illnesses and their risk factors and described healthcare use in this UK population. A cross-sectional, observational study was conducted at an outpatient HIV specialist clinic in south east England. Patients age ≥50 years were invited to complete questionnaires measuring demographics, non-infectious illnesses, medication use, lifestyle and healthcare utilisation. The response rate was 67%. Of 299 participants, 84% reported ≥1 comorbid condition and 61% reported ≥2 (multimorbidity). Most commonly reported were high cholesterol, sexual dysfunction, hypertension and depression. In multivariate analyses, age, number of years HIV-positive and duration of antiretroviral therapy remained significant predictors of comorbidity when controlling for lifestyle factors (exercise, smoking and use of recreational drugs and alcohol). Use of non-HIV healthcare services was associated with increasing comorbidity, a longer duration of HIV and recreational drug use. The majority of HIV-patients aged ≥50 years reported multiple comorbidities and this was associated with polypharmacy and increased use of non-HIV services. Further research examining the quality, safety and patient experience of healthcare is needed to inform development of services to optimally meet the needs of older HIV-positive patients.
authors.affiliation: HIV/GUM Research, Brighton and Sussex University Hospitals NHS Trust, London, UK.
authors.forename: Roshani
authors.initials: R
authors.lastname: Patel
authors.affiliation: HIV/GUM Research, Brighton and Sussex University Hospitals NHS Trust, London, UK.
authors.forename: Thomas
authors.initials: T
authors.lastname: Moore
authors.affiliation: HIV/GUM Research, Brighton and Sussex University Hospitals NHS Trust, London, UK vanessa.cooper@bsuh.nhs.uk.
authors.forename: Vanessa
authors.initials: V
authors.lastname: Cooper
authors.affiliation: HIV/GUM Research, Brighton and Sussex University Hospitals NHS Trust, London, UK.
authors.forename: Conor
authors.initials: C
authors.lastname: McArdle
authors.affiliation: Brighton and Sussex Medical School, Brighton, UK.
authors.forename: Nicky
authors.initials: N
authors.lastname: Perry
authors.affiliation: School of Computing, Engineering and Mathematics, University of Brighton, Brighton, UK.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Cheek
authors.affiliation: HIV/GUM Research, Brighton and Sussex University Hospitals NHS Trust, London, UK Brighton and Sussex Medical School, Brighton, UK.
authors.forename: Nicola
authors.initials: N
authors.lastname: Gainsborough
authors.affiliation: HIV/GUM Research, Brighton and Sussex University Hospitals NHS Trust, London, UK Brighton and Sussex Medical School, Brighton, UK.
authors.forename: Martin
authors.initials: M
authors.lastname: Fisher
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D023241:Antiretroviral Therapy, Highly Active; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology*; D011307:Drug Prescriptions / Q000706:statistics & numerical data; D004739:England / Q000453:epidemiology; D005260:Female; D015658:HIV Infections / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology; D006801:Humans; D006937:Hypercholesterolemia / Q000453:epidemiology*; D006973:Hypertension / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D019338:Polypharmacy; D015995:Prevalence; D012307:Risk Factors; D012735:Sexual Dysfunction, Physiological / Q000453:epidemiology*; D011795:Surveys and Questionnaires
keywords: AIDS; HIV; ageing; antiretroviral therapy; comorbid disease; elderly care; healthcare utilisation; multimorbidity