Concurrent Use of Comedications Reduces Adherence to Antiretroviral Therapy Among HIV-Infected Patients

• DOI: 10.18553/jmcp.2014.20.8.844
• Publication Date: 2016-02-16T18:21:56Z
• Authors: Maria Rosa Cantud...; Rocio Jiménez-Galán; Carmen V. Almeida...; Ramón Morillo-Ver...
• Keywords: Hepatitis C; Pharmacotherapy

The use of highly active antiretroviral therapy has significantly reduced morbidity and mortality, thus increasing life expectancy human immunodeficiency virus (HIV)-infected individuals, transforming HIV into a chronic disease. Accordingly, there been an increase in the number comorbidities concomitantly present these individuals also increased comedications, which may negatively impact adherence. These factors can affect adherence to therapy. role clinical pharmacist is essential achieve therapeutic objectives enhance adherence.To determine influence comedications on among HIV-infected patients receiving services from pharmacist.We conducted prospective observational study that included outpatients who attended pharmaceutical care office hospital pharmacy service, initiated treatment between January 2002, December 2011. variables analyzed were demographics (sex age), transmission mode, following at time comedication collection: hepatitis C or B coinfection, plasma viral load (copies/mL) CD4+ T-cell count (cells/µL), Centers for Disease Control Prevention classification, admissions emergency room visits, therapy-related features (type baseline, treatment-naïve status, changes since starting therapy). For follow-up 12 months, was measured through dispensing records Morisky Medication Adherence Scale (MMAS). Patients considered adherent if greater than 90%, MMAS score 4. Other other diseases (non-HIV drugs). According comorbidities, categorized as having multiple conditions (polypathology) they had 2 more diseases. Polypharmacy defined specifically 5 prescription medications medication regimen. In addition, complexity index calculated each patient. We determined risk drug-related problems using tool Predictor Index. To identify independent predictors therapy, we performed univariate logistic regression. Afterward, those showed statistical significance analysis with P less 0.25 multivariate model. sample size estimated by Freeman equation.We 594 (80.1% men, median age 47 years). analysis, statistically significant relationships detectable load, count, AIDS-defining condition, admission, therapy-naïve treatment, type high problems, polypathology, polypharmacy. Multivariate nonadherence intravenous drug (OR = 0.56, 95% CI 0.35-0.90), previous 0.09, 0.04-0.24), nontreatment 0.12, 0.05-0.31), 0.38, 0.23-0.63), polypharmacy 0.36, 0.21-0.61). value Hosmer Lemeshow test confirmed validity this model (P 0.378).Recently, higher, nonadherence. Furthermore, use, are associated lower