It's not all about ARVs: Investigating the proportion of patients on non-antiretroviral medication that interact with their HIV drugs

NMUH Staff Publications

EMBASE

16

<span style="font-size: 10pt;">Background: The success of anti-retrovirals (ARVs) has significantly improved the HIV health outcomes for patients. Today HIV patients are living longer and are more likely to be treated by other physicians for other aliments or obtain medication from different sources outside their HIV clinic. The aim of this study was to investigate the proportion of HIV patients within our clinic on ARVs that are also taking non-HIV medication which have drug-drug interactions with their ARV treatment. Method: Participants were invited to complete a questionnaire on their medication history between 28/04/2014 and 06/06/2014 (6 weeks). This questionnaire was development by the clinical pharmacy department and validated by the research team within the Trust. Patients that were identified as taking non-ARVs together with their ARVs were reviewed by the specialist pharmacist. All the medicines were assessed for possible interaction using the website www.hiv-druginteractions.org and the drug SPC (specific product characteristic). Drug interactions were categorised into three groups; managed, not managed and unknown management. Results: 323 questionnaires were collected, 23 questionnaires were incomplete so 300 questionnaires were analysed. 188/300(63%) patients were taking concomitant non-ARVs. 107(57%) patients had at least one drug interaction with their ARVs. 56/107(52%) of these patients with known interactions were classified as 'not managed' or 'unknown management'. 72/ 300(24%) were on over-the-counter medication either regularly or 'when required' and 13/300(5%) were taking traditional/herbal medication. 251/300 (86%) had informed their GP of their HIV status. There was an association between the accuracy of electronic patient records and the risk of interaction. Those with inaccurate records, had three times the odds of having an interaction compared to those with accurate records, (OR 2.8, p=0.0025, 95% CI:1.4 - 5.7). Conclusion: A high proportion of patients in our clinic are on non-HIV medication. A significant proportion of these drugs can interact with their ARVs. It is important to have 2-way communication with GPs and other specialist consultants so patients' medication history can be up-to-date and to ensure appropriate management of HIV and non-HIV care. Maintained electronic patient records and other innovative ways to improve documentation and communication are essential for improving standards of care. (Conference abstract)</span>