Background and importance The effectiveness of current antiretroviral treatments has prolonged the survival of HIV patients, and with age, the prevalence of comorbidities increases. The new clinical conditions of these patients may cause potentially inappropriate prescriptions.
Aim and objectives The aim of this study was to identify potentially inappropriate prescriptions in a HIV population over 65 years of age and to verify differences between physicians’ prescriptions and actual patient receipt of medications.
Material and methods This was an observational study of elderly HIV patients (≥65 years) who collected antiretroviral treatment (ART) at the pharmacy of a third level hospital between June and November 2018. The electronic prescription was checked against what the patient reported taking, to be sure of the real treatment taken by the patient. The confirmed treatments were evaluated with STOPP and LESS-CHRON criteria.
Results Thirty patients met the inclusion criteria. Based on the STOPP criteria, de-prescription of one medication was detected in 63.3% of patients, and in 60.0% of patients with the LESS-CHRON model. The most frequent type of drug affected by both criteria were benzodiazepines, followed by antidepressants in the case of STOPP and antiaggregants in the case of LESS-CHRON. The total number of patients who may be candidates for de-prescription by meeting the criteria with one or the other method was 70%. The total number of drugs prescribed was significantly associated (p=0.008) with meeting de-prescription criteria. Discrepancies between physicians` prescriptions and real patient takings were found in 23% of patients.
Conclusion and relevance There was a high prevalence of meeting de-prescription criteria in elderly HIV patients and a clear relationship between polypharmacy and de-prescription. Benzodiazepines were the most frequent drugs meeting the conditions of de-prescription. To obtain a complete record of a patient‘s treatment, it is necessary to complement the electronic medical record with a suitable clinical interview. It is important to periodically re-evaluate the need for treatment in chronic patients, with special interest in high risk drugs in the elderly.
References and/or acknowledgements http://dx.doi.org/10.1136/ejhpharm-2017-001251
No conflict of interest.
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