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Other Hospital Pharmacy topics (including: medical devices)
Different dose regimens of darunavir and its adherence
  1. I. Camaron,
  2. B. Sánchez Nevado,
  3. M. Nogales García,
  4. A. Martiarena Ayestarán,
  5. A.C. Minguez Cabeza,
  6. L. Guisasola Ron,
  7. C. Martínez Martínez
  1. 1Hospital Txagorritxu, Pharmacy, Vitoria, Spain

Abstract

Background Darunavir was approved at a dose regimen of 600 mg twice daily, in combination with other antiretroviral agents, by the Hospital's Pharmacy and Therapeutic Commission (CFT) in 2007 for treatment of HIV in adult patients that had been highly pretreated and had failed more than one prior therapy. In 2010, it was also approved for naïve patients in a dose regimen of 800 mg once daily. A patient is considered good compliant when adherence is above 90%, poorly compliant when it is between 80-90% and non-adherent when it is below 80%.

Purpose To evaluate the different posologies of darunavir/ritonavir used for the treatment of HIV infection in daily clinical practice.

Materials and methods A retrospective observational study of patients treated with darunavir since its inclusion in the Hospital's Pharmaceutical Guide (October 2007) until April 2011. Data were collected from AS-400 software which includes outpatient's dispensations. Adherence to treatment was estimated as the difference (as a percentage) between units of medication that should have been dispensed taking into account the dosage, and units that are registered in our software to have been dispensed in the last year.

Results 60 patients were treated with darunavir during this period, 42 men and 18 women. 32 of these 60 patients (53.3%) had 800 mg once daily dose regimen and 28 (46.7%) 600 mg twice daily. Only 14 of the 32 patients (43.8%) with the 800 mg dose regimen were naïve. All patients with the 600 mg dose regimen had been highly pretreated. With regard to adherence to antiretroviral treatment, The authors had data of 46 patients. 76.2% (16/21) of patients treated with 800 mg/day were good compliant, 9.5% (2/21) poorly compliant and 14.3% (3/21) non-compliant. In case of patients treated with 600 mg twice daily, 88.0% (22/25) were good adherent, 4.0% (1/25) bad adherent and 8.0% (2/25) non-adherent.

Conclusions In daily clinical practice, the indications approved by the CFT were not followed by clinicians. Although the dose regimen of a single daily dose aimed to simplify the antiretroviral therapy and improve adherence, The authors can not say that these patients were more adherent. Furthermore, The authors should take into account that adherence to treatment is influenced by more factors.

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