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
| Autor: | Theonestina Byakuzana, Farida Bani, Julius Mkumbo, Silyakus Mlembe, Agatha Ngulukila, Anna Gamell, Lameck B Luwanda, George Sikalengo, Yassin Kisunga, Adolphina Chale, Mengi Mkulila, Wilson Herieth, Sanula Nahota, Masawa Ngisi Peter, Elizabeth Senkoro, John Wigay, Maja Weisser, Lilian Moshi, Thomas Klimkait, Aschola Asantiel, Gideon Foe, Germana Mossad, Hansjakob Furrer, Olivia Kitau, Dolores Mpundunga, Speciosa Hwaya, Emilio Letang, Robert Ndege, Sauli John Epimack, Regina Ndaki, Leila Samson, Aneth V Kalinjuma, Anna Eichenberger, Andrea Kuemmerle, Tracy R. Glass, Athumani Mtandanguo, Fiona Vanobberghen, Yvan Temba, Herry Mapesi, Andrew Katende, Manuel Battegay, Dorcas Mnzava, Gertrud J Mollel, Christian Burri, Jenifa Tarimo, Daniel H. Paris, Alex J. Ntamatungiro, Chloé Schlaeppi, Catia Marzolini, Omary Rajab Ngome, Selerine Myeya, Margareth Mkusa, Amina Nyuri, James Okuma, Ezekiel Luoga, Joshua Kapunga, Bryson Kasuga, Juerg Utzinger, Namvua Kimera |
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| Rok vydání: | 2021 |
| Předmět: |
0301 basic medicine
Microbiology (medical) Drug Adult medicine.medical_specialty media_common.quotation_subject Human immunodeficiency virus (HIV) HIV Infections Disease medicine.disease_cause Logistic regression Tanzania 03 medical and health sciences 0302 clinical medicine Surveys and Questionnaires Pharmacovigilance Medicine Humans Pharmacology (medical) Drug Interactions 030212 general & internal medicine Prospective Studies Medical prescription media_common Pharmacology biology business.industry Middle Aged biology.organism_classification 030112 virology Infectious Diseases Pharmaceutical Preparations Family medicine Cohort Female business |
| Zdroj: | The Journal of antimicrobial chemotherapy. 76(10) |
| ISSN: | 1460-2091 |
| Popis: | Background 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. Objectives 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). Methods 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. Results 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). Conclusions 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. |
| Databáze: | OpenAIRE |
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