What is polypharmacy in people living with HIV/AIDS? A systematic review
- PMID: 35918746
- PMCID: PMC9344688
- DOI: 10.1186/s12981-022-00461-4
What is polypharmacy in people living with HIV/AIDS? A systematic review
Abstract
Polypharmacy in people living with HIV/AIDS (PLWHA) is a rising morbidity that exacts hefty economic burden on health budgets in addition to other adverse clinical outcomes. Despite recent advances, uncertainty remains around its exact definition in PLWHA. In this systematic review and Meta-analysis, we explored relevant databases (PUBMED, EMBASE, CROI) for studies evaluating polypharmacy in PLWHA from January 2000 to August 2021 to ascertain the exact numerical threshold that defines this morbidity. Two independent reviewers extracted and reviewed relevant variables for analyses. The review included a total of 31 studies involving n = 53,347 participants with a mean age of 49.5 (SD ± 17.0) years. There was a total of 36 definitions, with 93.5% defining polypharmacy as the concomitant use of 5 or more medications. We found significant variation in the numerical definition of polypharmacy, with studies reporting it as "minor" (N = 3); "major" (N = 29); "severe" (N = 2); "excessive" (N = 1); and "higher" (N = 1). Most studies did not incorporate a duration (84%) in their definition and excluded ART medications (67.7%). A plurality of studies in PLWHA have established that polypharmacy in this cohort of patients is the intake of ≥ 5 medications (including both ART and non-ART). To standardize the approach to addressing this rising morbidity, we recommend incorporation of this definition into national and international PLWHA treatment guidelines.
Keywords: AIDS; Antiretroviral; Drug interactions; HIV; PLWHA; Polypharmacy.
© 2022. The Author(s).
Conflict of interest statement
None of the authors have any competing interests to declare.
Figures
Similar articles
-
Pharmacist-Involved Antiretroviral Stewardship Programs in People Living with HIV/AIDS: A Systematic Review.AIDS Patient Care STDS. 2023 Jan;37(1):31-52. doi: 10.1089/apc.2022.0192. AIDS Patient Care STDS. 2023. PMID: 36626156
-
Cancer incidence in people living with HIV/AIDS in Israel, 1981-2010.AIDS Res Hum Retroviruses. 2015 Sep;31(9):873-81. doi: 10.1089/aid.2015.0022. Epub 2015 Jun 15. AIDS Res Hum Retroviruses. 2015. PMID: 25941873
-
Suboptimal immune recovery and associated factors among people living with HIV/AIDS on second-line antiretroviral therapy in central China: A retrospective cohort study.J Med Virol. 2022 Oct;94(10):4975-4982. doi: 10.1002/jmv.27944. Epub 2022 Jul 10. J Med Virol. 2022. PMID: 35710693
-
Prevalence and global trends of polypharmacy among people living with HIV: a systematic review and meta-analysis.Ther Adv Drug Saf. 2022 Aug 23;13:20420986221080795. doi: 10.1177/20420986221080795. eCollection 2022. Ther Adv Drug Saf. 2022. PMID: 36052397 Free PMC article.
-
Risky sexual practice and associated factors among people living with HIV/AIDS receiving antiretroviral therapy in Ethiopia: Systematic review and meta-analysis.PLoS One. 2022 Apr 14;17(4):e0266884. doi: 10.1371/journal.pone.0266884. eCollection 2022. PLoS One. 2022. PMID: 35421163 Free PMC article.
Cited by
-
Prevalence and global trends of polypharmacy in patients with chronic liver disease: A systematic review and meta-analysis.Medicine (Baltimore). 2023 May 12;102(19):e32608. doi: 10.1097/MD.0000000000032608. Medicine (Baltimore). 2023. PMID: 37171329 Free PMC article.
-
Dual trajectories of antiretroviral therapy adherence and polypharmacy in women with HIV in the United States.AIDS Res Ther. 2023 May 13;20(1):29. doi: 10.1186/s12981-023-00520-4. AIDS Res Ther. 2023. PMID: 37179294 Free PMC article.
-
Prevalence of medication overload among older people with HIV: a MedSafer study.BMC Infect Dis. 2024 Oct 25;24(1):1204. doi: 10.1186/s12879-024-10105-9. BMC Infect Dis. 2024. PMID: 39455936 Free PMC article.
-
Polypharmacy and Aging in People Living with HIV: 6 Years of Experience in a Multidisciplinary Outpatient Clinic.Drugs Aging. 2023 Jul;40(7):665-674. doi: 10.1007/s40266-023-01037-1. Epub 2023 Jun 13. Drugs Aging. 2023. PMID: 37310576
-
Balancing polypharmacy and comorbidity management: cardiovascular health.Curr Opin HIV AIDS. 2025 Jul 1;20(4):409-415. doi: 10.1097/COH.0000000000000948. Epub 2025 May 13. Curr Opin HIV AIDS. 2025. PMID: 40397570 Review.
References
-
- Guaraldi G, Malagoli A, Calcagno A, Mussi C, Celesia BM, Carli F, Piconi S, De Socio GV, Cattelan AM, Orofino G. The increasing burden and complexity of multi-morbidity and polypharmacy in geriatric HIV patients: a cross sectional study of people aged 65–74 years and more than 75 years. BMC Geriatr. 2018;18(1):99. doi: 10.1186/s12877-018-0789-0. - DOI - PMC - PubMed
-
- Sullivan PS, Satcher Johnson A, Pembleton ES, Stephenson R, Justice AC, Althoff KN, Bradley H, Castel AD, Oster AM, Rosenberg ES, Mayer KH, Beyrer C. Epidemiology of HIV in the USA: epidemic burden, inequities, contexts, and responses. Lancet. 2021;397(10279):1095–1106. doi: 10.1016/S0140-6736(21)00395-0. - DOI - PubMed
-
- McIsaac DI, Wong CA, Bryson GL, van Walraven C. Association of polypharmacy with survival, complications, and healthcare resource use after elective noncardiac surgery: a population-based cohort study. Anesthesiol J Am Soc Anesthesiol. 2018;128(6):1140–1150. - PubMed
Publication types
MeSH terms
LinkOut - more resources
Full Text Sources
Medical