Examination of Polypharmacy Trajectories Among HIV-Positive and HIV-Negative Men in an Ongoing Longitudinal Cohort from 2004 to 2016

Deanna Ware, Frank J. Palella, Kara W. Chew, M. Reuel Friedman, Gypsyamber D'Souza, Ken Ho, Michael Plankey

Research output: Contribution to journalArticle

Abstract

Polypharmacy is the concurrent use of five or more medications. We used group-based trajectory analysis to identify groups of non-HIV medication polypharmacy and investigate associated risk factors among HIV-positive and HIV-negative men in the Multicenter AIDS Cohort Study (MACS) from 2004 to 2016. Each participant was assigned to mutually exclusive groups based on their observed patterns of polypharmacy over time. Risk factors associated with membership with resulting groups were investigated using a multinomial generalized logit model with repeated measures. There were 3160 participants (54.3% HIV positive) included in the study. The overall prevalence of polypharmacy was 33.1% and was higher in HIV-positive than HIV-negative participants (36.2% vs. 30.0%; p < 0.001). Four distinct groups of polypharmacy emerged over time among all participants and among HIV-positive participants only: (1) nonpolypharmacy, (2) slow increasing polypharmacy, (3) rapid increasing polypharmacy, and (4) sustained polypharmacy. Being HIV positive, being 50 years of age or older, having medication insurance coverage, and having increased health care use were positively associated with membership in groups with sustained or increasing polypharmacy. Half of participants in each analysis had membership in one of the three high polypharmacy groups. This study revealed that access to care, through medication insurance coverage and health care use, was a key driver of polypharmacy in this cohort. Further exploration of medically appropriate and inappropriate prescribing practices in the context of polypharmacy and its impact on health outcomes in this and other populations is warranted.

Original languageEnglish (US)
Pages (from-to)354-365
Number of pages12
JournalAIDS patient care and STDs
Volume33
Issue number8
DOIs
StatePublished - Aug 1 2019

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Polypharmacy
HIV
Insurance Coverage
Inappropriate Prescribing
Delivery of Health Care
Acquired Immunodeficiency Syndrome
Cohort Studies

Keywords

  • HIV/AIDS
  • longitudinal cohort
  • medications
  • MSM
  • polypharmacy

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Infectious Diseases

Cite this

Examination of Polypharmacy Trajectories Among HIV-Positive and HIV-Negative Men in an Ongoing Longitudinal Cohort from 2004 to 2016. / Ware, Deanna; Palella, Frank J.; Chew, Kara W.; Friedman, M. Reuel; D'Souza, Gypsyamber; Ho, Ken; Plankey, Michael.

In: AIDS patient care and STDs, Vol. 33, No. 8, 01.08.2019, p. 354-365.

Research output: Contribution to journalArticle

Ware, Deanna ; Palella, Frank J. ; Chew, Kara W. ; Friedman, M. Reuel ; D'Souza, Gypsyamber ; Ho, Ken ; Plankey, Michael. / Examination of Polypharmacy Trajectories Among HIV-Positive and HIV-Negative Men in an Ongoing Longitudinal Cohort from 2004 to 2016. In: AIDS patient care and STDs. 2019 ; Vol. 33, No. 8. pp. 354-365.
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