Multidisciplinary Care for Older People With HIV: Optimizing Medication and Enhancing Quality of Life

The growing number of older people with HIV (PWH) presents challenges in comprehensive care and maintaining health-related quality of life (HRQoL). This study aimed to evaluate the effect of a multidisciplinary intervention focusing on medication optimization and person-centered support on the HRQoL of older PWH.

This prospective study included 3 groups: PWH ≥ 50 years (older); PWH < 50 years (younger); and HIV-negative individuals ≥ 50 years. Older PWH underwent a comprehensive assessment at baseline and approximately 6 months later, with interventions provided by clinical pharmacists, infectious disease specialists, and geriatricians. Medication Regimen Complexity Index (MRCI), STOPP/START and TIME criteria, and 36-Item Short Form Health Survey (SF-36) were used.

A total of 285 participants were included in this study (50% older PWH, 25% younger PWH, and 25% HIV-negative individuals). The mental component summary score of SF-36 was significantly higher in older PWH compared to younger PWH at baseline (P = .001). Antiretroviral therapy regimens were simplified in 24.1%, and at least 1 medication was deprescribed in 48.9% of older PWH. Older PWH demonstrated significant reductions in potentially inappropriate prescribing with STOPP/START and TIME criteria (P < .001) at the second interview, but no significant changes were observed in MRCI scores (P > .05). Additionally, physical and mental component summary scores of SF-36 increased significantly (P = .012 and P < .001, respectively) after intervention.

Multidisciplinary care was associated over time with reductions in inappropriate prescribing and improvements in HRQoL among older PWH. These findings underscore the need for integrated, person-centered, age-tailored HIV care models to support healthy aging.