Among PLWH age 65 or older, polypharmacy is quite common, but the rate of potential drug-drug interactions is similar when comparing older and younger people, a study published in Open Forum Infectious Diseases showed.
In the context of this research, polypharmacy was defined as taking five or more medications in addition to antiretrovirals. Among 996 participants in the Swiss HIV Cohort Study (122 ≥ 65 years), 44% aged ≥ 65 years met that definition, compared to 12% of those < 65 years old.
Older participants most commonly took cardiovascular drugs (73% in older group had been prescribed at least one such medication), while central nervous system drugs predominated among the younger group (26% in younger group).
Logically, one might assume that drug-drug interactions are a greater concern among older PLWH—after all, many such people have taken HIV medications for a long time and may have developed resistance against some antiretrovirals, leading them to take complicated HIV treatment regimens, study authors noted. For example, one particular concern would be the co-prescription of boosted protease inhibitors and the antiplatelet medication clopidogrel.
However, the rate of potential drug-drug interactions found in the study was 11%—a percentage that did not differ between age groups. This may be because the health care providers who care for patients enrolled in the Swiss HIV Cohort Study are more aware of such problems and adjust their prescriptions accordingly, study authors suggested.
Nonetheless, the authors recommended periodic medication reviews to curb the risk for interactions, and added that HIV providers should be educated in geriatric medicine principles.