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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Analysis of inappropriate prescribing in elderly patients of the Swiss HIV Cohort Study reveals gender inequity
Journal of Antimicrobial Chemotherapy, Volume 76, No. 3, Year 2021
Notification
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Description
Background: The extent of inappropriate prescribing observed in geriatric medicine has not been thoroughly evaluated in people ageing with HIV. We determined the prevalence of and risk factors for inappropriate prescribing in individuals aged ≥75 years enrolled in the Swiss HIV Cohort Study. Methods: Retrospective review of medical records was performed to gain more insights into non-HIV comorbidities. Inappropriate prescribing was screened using the Beers criteria, the STOPP/START criteria and the Liverpool drug-drug interactions (DDIs) database. Results: For 175 included individuals, the median age was 78 years (IQR 76-81) and 71% were male. The median number of non-HIV comorbidities was 7 (IQR 5-10). The prevalence of polypharmacy and inappropriate prescribing was 66% and 67%, respectively. Overall, 40% of prescribing issues could have deleterious consequences. Prescribing issues occurred mainly with non-HIV drugs and included: Incorrect dosage (26%); lack of indication (21%); prescription omission (drug not prescribed although indicated) (17%); drug not appropriate in elderly individuals (18%) and deleterious DDIs (17%). In the multivariable logistic regression, risk factors for prescribing issues were polypharmacy (OR: 2.5; 95% CI: 1.3-4.7), renal impairment (OR: 2.7; 95% CI: 1.4-5.1), treatment with CNS-active drugs (OR: 2.1; 95% CI: 1.1-3.8) and female sex (OR: 8.3; 95% CI: 2.4-28.1). Conclusions: Polypharmacy and inappropriate prescribing are highly prevalent in elderly people living with HIV. Women are at higher risk than men, partly explained by sex differences in the occurrence of non-HIV comorbidities and medical care. Medication reconciliation and periodic review of prescriptions by experienced physicians could help reduce polypharmacy and inappropriate prescribing in this vulnerable, growing population. © 2021 The Author(s). Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved.
Authors & Co-Authors
Elzi, Luigia
Unknown Affiliation
Braun, Dominique Laurent
Switzerland, Zurich
Universitatsspital Zurich
Calmy, Alexandra L.
Switzerland, Geneva
Hôpitaux Universitaires de Genève
Cavassini, Matthias
Switzerland, Lausanne
Centre Hospitalier Universitaire Vaudois
Tarr, Philip E.
Switzerland, Basel
Universitat Basel
Battegay, Manuel
Switzerland, Basel
Universitat Basel
Switzerland, Basel
Universitätsspital Basel
Marzolini, Catia
Switzerland, Basel
Universitat Basel
Switzerland, Basel
Universitätsspital Basel
United Kingdom, Liverpool
University of Liverpool
Aebi-Popp, Karoline
Unknown Affiliation
Anagnostopoulos, Alexia
Unknown Affiliation
Bernasconi, Enos
Unknown Affiliation
Böni, Jürg
Unknown Affiliation
Braun, Dominique L.
Unknown Affiliation
Bucher, Heíner C.C.
Unknown Affiliation
Cavassini, Matthias
Unknown Affiliation
Ciuffi, Angela
Unknown Affiliation
Dollenmaier, Guenter
Unknown Affiliation
Egger, Matthias
Unknown Affiliation
Fehr, Jan Sven
Unknown Affiliation
Fellay, Jacques
Unknown Affiliation
Furrer, Hansjakob Jackob
Unknown Affiliation
Fux, Christoph Andreas
Unknown Affiliation
Günthard, Huldrych F.
Unknown Affiliation
Haerry, David Hans Ulrich
Unknown Affiliation
Hasse, Barbara Katharina
Unknown Affiliation
Hirsch, Hans H.
Unknown Affiliation
Hoffmann, Matthias
Unknown Affiliation
Hösli, Irene Mathilde
Unknown Affiliation
Huber, Michael J.
Unknown Affiliation
Kahlert, Christian R.
Unknown Affiliation
Kaiser, Laurent K.
Unknown Affiliation
Keiser, Olivia
Unknown Affiliation
Klimkait, Thomas
Unknown Affiliation
Kouyos, Roger D.
Unknown Affiliation
Kovari, Helen
Unknown Affiliation
Ledergerber, Bruno
Unknown Affiliation
Martinetti, Gladys
Unknown Affiliation
Martinez de Tejada, Begoña
Unknown Affiliation
Metzner, Karin Jutta
Unknown Affiliation
Müller, Nicolas J.
Unknown Affiliation
Nicca, Dunja
Unknown Affiliation
Paioni, Paolo
Unknown Affiliation
Pantaleo, Giuseppe P.
Unknown Affiliation
Perreau, Matthieu
Unknown Affiliation
Rauch, Andri
Unknown Affiliation
Rudin, Christoph
Unknown Affiliation
Scherrer, Alexandra U.
Unknown Affiliation
Schmid, Patrick
Unknown Affiliation
Speck, Roberto F.
Unknown Affiliation
Stöckle, Marcel
Unknown Affiliation
Trkola, Alexandra
Unknown Affiliation
Vernazza, Pietro Luigi
Unknown Affiliation
Wandeler, Gilles
Unknown Affiliation
Weber, Rainer
Unknown Affiliation
Yerly, Sabine T.B.D.
Unknown Affiliation
Statistics
Citations: 14
Authors: 54
Affiliations: 9
Identifiers
Doi:
10.1093/jac/dkaa505
ISSN:
03057453
Research Areas
Cancer
Health System And Policy
Infectious Diseases
Study Design
Cross Sectional Study
Cohort Study
Study Approach
Quantitative
Participants Gender
Male
Female