Polypharmacy in older adults with human immunodeficiency virus infection compared with the general population.
BACKGROUND
The percentage of older HIV-positive patients is growing, with an increase in age-related comorbidities and concomitant medication.


OBJECTIVE
To quantify polypharmacy and profile types of non-antiretroviral drugs collected at community pharmacies in 2014 by HIV-positive individuals on antiretroviral therapy and to compare these findings with those of the general population.


METHODS
HIV-positive patients (n=199) were compared with a group of patients from the general population (n=8,172), aged between 50 and 64 years. The factors compared were prevalence of polypharmacy (≥5 comedications with cumulative defined daily dose [DDD] per drug over 180), percentage of patients who collected each therapeutic class of drug, and median duration for each drug class (based on DDD). Results were stratified by sex.


RESULTS
Polypharmacy was more common in HIV-positive males than in the male general population (8.9% vs 4.4%, P=0.010). Polypharmacy was also higher in HIV-positive females than in the female general population (11.3% vs 3.4%, P=0.002). Percentage of HIV-positive patients receiving analgesics, anti-infectives, gastrointestinal drugs, central nervous system (CNS) agents, and respiratory drugs was higher than in the general population, with significant differences between male populations. No differences were observed in proportion of patients receiving cardiovascular drugs. The estimated number of treatment days (median DDDs) were higher in HIV-positive males than in males from the general population for anti-infectives (32.2 vs 20.0, P<0.001) and CNS agents (238.7 vs 120.0, P=0.002). A higher percentage of HIV-positive males than males from the general population received sulfonamides (17.1% vs 1.5%, P<0.001), macrolides (37.1% vs 24.9%, P=0.020), and quinolones (34.3% vs 21.2%, P=0.009).


CONCLUSIONS
Polypharmacy is more common in HIV-positive older males and females than in similarly aged members of the general population. HIV-positive patients received more CNS drugs and anti-infectives, specifically sulfonamides, macrolides, and quinolones, but there were no differences in the percentage of patients receiving cardiovascular drugs. It is essential to investigate nonantiretroviral therapy medication use in the HIV-positive population to ensure these patients receive appropriate management.
Pharmacy Department, Lozano Blesa University Clinical Hospital, Aragon Institute for Health Research.
Mercedes
M
Gimeno-Gracia
Department of Infectious Diseases, Aragon Institute for Health Research, Lozano Blesa University Clinical Hospital.
María José
MJ
Crusells-Canales
Pharmacy Department, Aragon Health Service.
Francisco Javier
FJ
Armesto-Gómez
Pharmacy Department, Lozano Blesa University Clinical Hospital.
Vicente
V
Compaired-Turlán
Department of Public Health, University of Zaragoza, Zaragoza, Spain.
María José
MJ
Rabanaque-Hernández
D000368:Aged; D015897:Comorbidity; D005260:Female; D015658:HIV Infections / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019338:Polypharmacy; D012737:Sex Factors
HIV infection; aging; polypharmacy