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Original article

Polypharmacy and drug–drug interactions in older and younger people living with HIV: the POPPY study

Marie O Halloran, Catherine Boyle, Brona Kehoe, Emmanouil Bagkeris, Paddy Mallon, Frank A Post, Jamie Vera, Ian Williams, Jane Anderson, Alan Winston, Memory Sachikonye, Caroline Sabin, Marta Boffito

Corresponding author name: Marie O Halloran
Corresponding author e-mail: mohalloran@mater.ie

doi: 10.3851/IMP3293

Date accepted: 02 January 2019
Date published online: 31 January 2019

Abstract

Background: Polypharmacy (use of ≥ five medications) increases the risk of drug–drug interactions and can lead to negative health outcomes. This study aimed to review the medications of people living with HIV (PLWH) and HIV-negative controls in the POPPY study and evaluate the frequency of polypharmacy and potential drug–drug interactions (PDDIs).

Methods: PDDIs between non-antiretroviral (ARV) drugs were analysed using the Lexicomp® database, and PDDIs between non-ARV and ARV drugs using the Liverpool drug interaction database. Between-group differences were assessed using χ2, Mann–Whitney U and Kruskal–Wallis tests.

Results: This analysis included 698 PLWH ≥50 years, 374 PLWH <50 years and 304 HIV-negative controls ≥50 years. The prevalence of polypharmacy was 65.8% in older PLWH, 48.1% in younger PLWH and 13.2% in the HIV-negative group. When ARVs were excluded, 29.8% of older PLWH and 14.2% of younger PLWH had polypharmacy. The prevalence of ≥1 PDDI involving non-ARV drugs was 36.1%, 20.3% and 16.4%, respectively, in older PLWH, younger PLWH and HIV-negative controls. In PLWH the prevalence of ≥1 PDDI involving ARV and non-ARV drugs was 57.3% in older PLWH and 32.4% in younger PLWH.

Conclusions: Polypharmacy and PDDIs involving non-ARV/ARV drugs and non-ARV/non-ARV drugs were common among older PLWH, highlighting the need for increased awareness and additional research on all types of PDDI.

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