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Prescribing issues in elderly individuals living with HIV
Catia Marzolini1,2, Françoise Livio3
1a Division of Infectious Diseases and Hospital Epidemiology, Departments of Medicine and Clinical Research , University Hospital of Basel and University of Basel , Basel , Switzerland.
Expert Review of Clinical Pharmacology
|June 4, 2019
Summary
As people with HIV live longer, managing their health becomes complex due to aging. This review highlights prescribing challenges in older adults with HIV, emphasizing drug interactions and the need for specialized geriatric care.
Area of Science:
- Geriatric Medicine
- Infectious Diseases
- Pharmacology
Background:
- Combined antiretroviral therapy has shifted HIV infection to a chronic condition, increasing the lifespan of people living with HIV (PLWH).
- Aging PLWH face age-related comorbidities, polypharmacy, and increased risk of drug-drug or drug-disease interactions.
- Physiological changes in older adults impact drug pharmacokinetics and pharmacodynamics, raising risks for adverse drug reactions and prescribing cascades.
Purpose of the Study:
- To review the demographics of the aging HIV population.
- To discuss physiological changes and their impact on drug response in elderly PLWH.
- To highlight common prescribing issues, including drug-drug interactions, in elderly PLWH.
Main Methods:
- A comprehensive PubMed search was conducted to identify relevant publications up to February 2019.
- The review synthesizes information on the aging HIV population, physiological changes, comorbidities, and prescribing challenges.
- Emphasis is placed on drug-drug interactions involving antiretroviral drugs in this demographic.
Main Results:
- Prescribing issues are highly prevalent in elderly PLWH.
- Polypharmacy and inappropriate prescribing contribute to adverse health outcomes.
- Age-related physiological changes necessitate careful consideration of drug dosing and interactions.
Conclusions:
- There is a critical need for education on geriatric prescribing principles for healthcare providers managing elderly PLWH.
- Interventions such as medication reconciliation, review, and prioritization are essential to prevent harm.
- A multidisciplinary team approach is recommended for optimal care of elderly PLWH.
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