Background and importance The population with HIV is increasingly ageing. This premature ageing is estimated at 10 years. The consequence is that these patients suffer polymedication and more comorbidities than non-infected populations at earlier stages, and therefore are at risk of potentially inappropriate prescriptions (PIPs).
Aim and objectives To detect PIPs in patients with HIV using software, and to compare those detected with the best clinical judgment of the pharmacist.
Material and methods A cross sectional study was conducted in a tertiary hospital (11 March 2019–6 October 2019). Patients with HIV for ≥55 years who attended the outpatient pharmacy department were included. Patients were interviewed by a pharmacy student and data registered were age, sex, weight–height and domiciliary treatment. The student also checked (1) laboratory tests and registered creatinine values and (2) the medical records and registered last blood pressure values and all comorbidities. All of this information was included into the Checkthemeds software which detects STOPP/START criteria (V.2). Afterwards, pharmacists evaluated one by one all of the detected criteria using their best clinical judgment.
Results Ninety-five patients, 22 women (23%) and 73 men (77%), met the inclusion criteria with a median age of 62 years (55–83). Checkthemeds detected 32 different types of STOPP/START criteria in 77 patients (81%) with a total number of 234 PIPs. We found that 164 (70%) were STOPP criteria and 70 (30%) were START criteria. The most frequent STOPP criteria were A1 (n=103), D5 (n=23), A3 (n=12) and J3 (n=6). Among the START criteria, E3 (n=25), B2 (n=12) and E6 (n=5) were the most prevalent.
The pharmacists reviewed all the PIPs identified by the software and excluded 91 STOPP criteria (83 were A1 criteria, 6 were J3 and 2 were N1). Regarding START criteria, 21 were excluded (11 were B2 criteria, 5 were B1, 3 were F1, 1 was E2 and 1 was H2 criteria). There was an overestimation of the STOPP/START criteria of 112 (48%) using Checkthemeds.
Conclusion and relevance A large proportion of patients with HIV for ≥55 years have potentially inappropriate prescriptions, particularly drugs without an indication (A1 criteria), and one-third of patients required calcium+vitamin D prescriptions (E3 criteria). The pharmacist’s role is essential to interpret the results of CheckTheMeds and to identify the most appropriate interventions for each patient.
References and/or acknowledgements No conflict of interest.
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