Abstract：
OBJECTIVE: To determine DBI and its relationship with polypharmacy and pharmacotherapeutic complexity (PC) in a cohort of PLWH over 50 years of age at follow-up of pharmacotherapy in a tertiary hospital.
METHODS: Observational and retrospective study that included PLWH in active antiretroviral treatment over 50 years of age who have been followed up in outpatient pharmacy services. Pharmacotherapeutic complexity was estimated through Medication Regimen Complexity Index (MRCI). Collected variables included comorbidities, current prescriptions and its classification according to anticholinergic and sedative activity and associated risk of falls.
RESULTS: Studied population included 251 patients (85.7% men; median age: 58 years, interquartile range: 54-61). There was a high prevalence of high DBI scores (49.2%). High DBI was significantly correlated with a high PC, polypharmacy, psychiatric comorbidity and substances abuse (p<0.05). Among sedative drugs, the most prescribed were anxiolytic drugs (N05B) (n=85), antidepressant drugs (N06A) (n=41) and antiepileptic drugs (N03A) (n=29). For anticholinergic drugs, alpha-adrenergic antagonist drugs (G04C) were the most prescribed (n=18). Most frequent drugs associated with risk of falls were anxiolytics (N05B) (n=85), angiotensin-converting enzyme inhibitors (C09A) (n=61) and antidepressants (N06A) (n=41).
CONCLUSIONS: The DBI score in older PLWH is high and it is related to PC, polypharmacy, mental diseases and substance abuse as is the prevalence of fall-related drugs. Control of these parameters as well as the reduction of the sedative and anticholinergic load should be included in the lines of work in the pharmaceutical care of people living with HIV+.
METHODS: Observational and retrospective study that included PLWH in active antiretroviral treatment over 50 years of age who have been followed up in outpatient pharmacy services. Pharmacotherapeutic complexity was estimated through Medication Regimen Complexity Index (MRCI). Collected variables included comorbidities, current prescriptions and its classification according to anticholinergic and sedative activity and associated risk of falls.
RESULTS: Studied population included 251 patients (85.7% men; median age: 58 years, interquartile range: 54-61). There was a high prevalence of high DBI scores (49.2%). High DBI was significantly correlated with a high PC, polypharmacy, psychiatric comorbidity and substances abuse (p<0.05). Among sedative drugs, the most prescribed were anxiolytic drugs (N05B) (n=85), antidepressant drugs (N06A) (n=41) and antiepileptic drugs (N03A) (n=29). For anticholinergic drugs, alpha-adrenergic antagonist drugs (G04C) were the most prescribed (n=18). Most frequent drugs associated with risk of falls were anxiolytics (N05B) (n=85), angiotensin-converting enzyme inhibitors (C09A) (n=61) and antidepressants (N06A) (n=41).
CONCLUSIONS: The DBI score in older PLWH is high and it is related to PC, polypharmacy, mental diseases and substance abuse as is the prevalence of fall-related drugs. Control of these parameters as well as the reduction of the sedative and anticholinergic load should be included in the lines of work in the pharmaceutical care of people living with HIV+.
摘要：
目的：在三甲医院进行药物治疗随访时，在50岁以上的PLWH队列中确定DBI及其与多重用药和药物治疗复杂性（PC）的关系。
方法：观察性和回顾性研究，包括在门诊药学服务中随访的50岁以上积极抗逆转录病毒治疗的PLWH。药物治疗复杂性通过药物治疗方案复杂性指数（MRCI）进行评估。收集的变量包括合并症，当前的处方及其根据抗胆碱能和镇静活性以及相关跌倒风险的分类。
结果：研究人群包括251名患者（男性占85.7％；中位年龄：58岁，四分位数间距：54-61）。高DBI评分的患病率很高（49.2%）。高DBI与高PC显著相关，多药，精神病合并症和药物滥用(p<0.05)。在镇静药物中，处方最多的是抗焦虑药(N05B)(n=85)，抗抑郁药(N06A)(n=41)和抗癫痫药(N03A)(n=29)。对于抗胆碱能药物，α-肾上腺素能拮抗剂药物（G04C）是处方最多的（n=18）。与跌倒风险相关的最常见药物是抗焦虑药（N05B）（n=85），血管紧张素转换酶抑制剂（C09A）（n=61）和抗抑郁药（N06A）（n=41）。
结论：老年PLWH的DBI评分较高，与PC有关，多药，精神疾病和药物滥用以及与跌倒有关的药物的流行。控制这些参数以及减少镇静剂和抗胆碱能负荷应包括在艾滋病毒感染者的药物护理工作中。
方法：观察性和回顾性研究，包括在门诊药学服务中随访的50岁以上积极抗逆转录病毒治疗的PLWH。药物治疗复杂性通过药物治疗方案复杂性指数（MRCI）进行评估。收集的变量包括合并症，当前的处方及其根据抗胆碱能和镇静活性以及相关跌倒风险的分类。
结果：研究人群包括251名患者（男性占85.7％；中位年龄：58岁，四分位数间距：54-61）。高DBI评分的患病率很高（49.2%）。高DBI与高PC显著相关，多药，精神病合并症和药物滥用(p<0.05)。在镇静药物中，处方最多的是抗焦虑药(N05B)(n=85)，抗抑郁药(N06A)(n=41)和抗癫痫药(N03A)(n=29)。对于抗胆碱能药物，α-肾上腺素能拮抗剂药物（G04C）是处方最多的（n=18）。与跌倒风险相关的最常见药物是抗焦虑药（N05B）（n=85），血管紧张素转换酶抑制剂（C09A）（n=61）和抗抑郁药（N06A）（n=41）。
结论：老年PLWH的DBI评分较高，与PC有关，多药，精神疾病和药物滥用以及与跌倒有关的药物的流行。控制这些参数以及减少镇静剂和抗胆碱能负荷应包括在艾滋病毒感染者的药物护理工作中。
