Relationship Between Polypharmacy and Quality of Life Among People in 24 Countries Living With HIV

Details

• Journal Article:
  Preventing Chronic Disease (PCD)
• Personal Author:
  Okoli, Chinyere ; de los Rios, Patricia ; Eremin, Anton ; Brough, Gary ; Young, Benjamin ; Short, Duncan
• Description:
  Introduction ; People living with HIV (PLHIV) have greater risk of having multiple health conditions. We measured the relationship between increased medication and overall quality of life among PLHIV from 24 countries. ; Methods ; We analyzed data for 2,112 adult PLHIV on antiretroviral therapy (ART) in 24 countries who completed the 2019 Positive Perspectives survey. Polypharmacy was defined as taking 5 or more pills a day or currently taking medications for 5 or more conditions. Outcomes were self-rated overall health, treatment satisfaction, and self-reported virologic control. New treatment concerns were issues not prioritized at ART initiation but now deemed paramount. Data were analyzed with descriptive and multivariable statistics. ; Results ; Overall prevalence of polypharmacy was 42.1%. People reporting polypharmacy had significantly poorer health outcomes independent of existing comorbidities; their odds of treatment satisfaction, optimal overall health, and virologic control were lower by 27.0% (adjusted odds ratio AOR = 0.73; 95% CI, 0.59–0.91), 36.0% (AOR = 0.64; 95% CI, 0.53–0.78), and 46.0% (AOR = 0.54, 95% CI, 0.42–0.70), respectively, compared with those without polypharmacy (all P < .05). Most PLHIV (56.6%) were concerned about taking more medicines as they age, and 73.1% were interested in ARTs with fewer medicines. Top reasons for switching ART among those who had ever switched (n = 1,550) were to reduce severity and frequency of side effects (45.3%), number of pills (35.0%), or number of medicines (26.8%). People reporting polypharmacy had significantly higher odds of having new concerns relative to when they initiated ART, regarding risks of drug–drug interactions (AOR = 1.32; 95% CI, 1.02–1.71) and side effects (AOR = 1.31; 95% CI, 1.02–1.68). ; Conclusion ; Polypharmacy was associated with poorer health-related outcomes among PLHIV. Many PLHIV expressed concerns about side effects of ART. Clinicians should carefully consider patient preferences, comorbidities, and drug profiles when prescribing ART.
• Subjects:
  • Original Research
• Source:
  Prev Chronic Dis. 2020; 17
• ISSN:
  1545-1151
• Pubmed ID:
  32134717
• Pubmed Central ID:
  PMC7085909
• Document Type:
  Journal Article
• Volume:
  17
• Download URL:
  https://stacks.cdc.gov/view/cdc/86374/cdc_86374_DS1.pdf
• File Type:
  [PDF - 688.17 KB]
• Collection(s):
  Preventing Chronic Disease
• Main Document Checksum:
  urn:sha-512:5262d0b5e6b697b71bd9f0f0e5bb2ae9f14e5d26af8bd4b40ff56e2776dc67cbaec5541c3b544ee399341ab6dbaec3ee7b1362737baf40c552b54bcc930c03bc