Recognition and management of clinically significant drug-drug interactions between antiretrovirals and co-medications in a cohort of people living with HIV in rural Tanzania: a prospective questionnaire-based study.
Details
Request a copy Under indefinite embargo.UNIL restricted access
State: Public
Version: Final published version
License: Not specified
Serval ID
serval:BIB_62DE667887F5
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Recognition and management of clinically significant drug-drug interactions between antiretrovirals and co-medications in a cohort of people living with HIV in rural Tanzania: a prospective questionnaire-based study.
Journal
The Journal of antimicrobial chemotherapy
Working group(s)
KIULARCO Study Group
Contributor(s)
Asantiel A., Bani F., Battegay M., Byakuzana T., Chale A., Eichenberger A., John Epimack S., Foe G., Furrer H., Gamell A., Glass T.R., Hwaya S., V Kalinjuma A., Kapunga J., Kasuga B., Katende A., Kimera N., Kisunga Y., Kitau O., Klimkait T., Letang E., Luoga E., Luwanda L.B., Mapesi H., Ngisi Peter M., Mkulila M., Mkumbo J., Mkusa M., Mlembe S., Mnzava D.K., Mollel G.J., Moshi L., Mossad G., Mpundunga D., Mtandanguo A., Myeya S., Nahota S., Ndaki R., Ndege R.C., Ngome O.R., Ngulukila A., Ntamatungiro A.J., Nyuri A., Okuma J., Paris D.H., Samson L., Senkoro E., Sikalengo G., Tarimo J., Temba Y., Utzinger J., Vanobberghen F., Weisser M., Wigay J., Herieth W.
ISSN
1460-2091 (Electronic)
ISSN-L
0305-7453
Publication state
Published
Issued date
15/09/2021
Peer-reviewed
Oui
Volume
76
Number
10
Pages
2681-2689
Language
english
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov't ; Research Support, U.S. Gov't, Non-P.H.S.
Publication Status: ppublish
Publication Status: ppublish
Abstract
The extent to which drug-drug interactions (DDIs) between antiretrovirals (ARVs) and co-medications are recognized and managed has not been thoroughly evaluated in limited-resource settings.
This prospective questionnaire-based study aimed to determine the prevalence and risk factors for unrecognized/incorrectly managed DDIs in people living with HIV followed-up at the Chronic Diseases Clinic of Ifakara (CDCI) and enrolled in the Kilombero and Ulanga Antiretroviral Cohort (KIULARCO).
We prospectively included ARV-treated adults receiving ≥1 co-medication coming for a follow-up visit at the CDCI between March and July 2017. Using a structured questionnaire, physicians were requested to identify potentially clinically significant DDIs in the prescribed treatment, to provide recommendations for their management and to indicate any hurdles to implement the recommendations. Prescriptions were subsequently screened for DDIs using the Liverpool DDIs database. Identified clinically significant DDIs and their recommended management according to the DDIs database were compared with the information provided in the questionnaires.
Among 334 participants, the median age was 47 years (IQR = 40-56 years), 69% were female and 82% had ≥1 non-communicable disease (NCD). Overall, 129 participants had ≥1 clinically relevant DDI, which was not recognized and/or incorrectly managed in 56 participants (43%). Of those, 6 (11%) were due to limited monitoring options or medication affordability issues. In the multivariable logistic regression, the presence of ≥1 NCD was associated with an increased risk for unrecognized/incorrect DDI management (OR = 15.8; 95% CI = 1.8-139.6).
Recognition/appropriate management of DDIs is suboptimal, highlighting the need for educational programmes, pharmacovigilance activities and increased access to medications and monitoring options. This should become a focus of HIV programmes given the increasing burden of NCDs in sub-Saharan Africa.
This prospective questionnaire-based study aimed to determine the prevalence and risk factors for unrecognized/incorrectly managed DDIs in people living with HIV followed-up at the Chronic Diseases Clinic of Ifakara (CDCI) and enrolled in the Kilombero and Ulanga Antiretroviral Cohort (KIULARCO).
We prospectively included ARV-treated adults receiving ≥1 co-medication coming for a follow-up visit at the CDCI between March and July 2017. Using a structured questionnaire, physicians were requested to identify potentially clinically significant DDIs in the prescribed treatment, to provide recommendations for their management and to indicate any hurdles to implement the recommendations. Prescriptions were subsequently screened for DDIs using the Liverpool DDIs database. Identified clinically significant DDIs and their recommended management according to the DDIs database were compared with the information provided in the questionnaires.
Among 334 participants, the median age was 47 years (IQR = 40-56 years), 69% were female and 82% had ≥1 non-communicable disease (NCD). Overall, 129 participants had ≥1 clinically relevant DDI, which was not recognized and/or incorrectly managed in 56 participants (43%). Of those, 6 (11%) were due to limited monitoring options or medication affordability issues. In the multivariable logistic regression, the presence of ≥1 NCD was associated with an increased risk for unrecognized/incorrect DDI management (OR = 15.8; 95% CI = 1.8-139.6).
Recognition/appropriate management of DDIs is suboptimal, highlighting the need for educational programmes, pharmacovigilance activities and increased access to medications and monitoring options. This should become a focus of HIV programmes given the increasing burden of NCDs in sub-Saharan Africa.
Keywords
Adult, Drug Interactions, Female, HIV Infections/drug therapy, Humans, Middle Aged, Pharmaceutical Preparations, Prospective Studies, Surveys and Questionnaires, Tanzania/epidemiology
Pubmed
Web of science
Create date
25/08/2023 5:17
Last modification date
19/09/2024 14:38
Usage data
