Editorial
Mind the polypharmacy in people living with HIV. A new challenge for the fourth 90
Atención a la polifarmacia en las personas que viven con VIH. Un nuevo reto para el cuarto 90
Read
640
Timeswas read the article
112
Total PDF
528
Total HTML
Share statistics
array:24 [ "pii" => "S2529993X21002604" "issn" => "2529993X" "doi" => "10.1016/j.eimce.2021.11.007" "estado" => "S300" "fechaPublicacion" => "2022-01-01" "aid" => "2519" "copyright" => "Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica" "copyrightAnyo" => "2021" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "edi" "cita" => "Enferm Infecc Microbiol Clin. 2022;40:5-6" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "Traduccion" => array:1 [ "en" => array:19 [ "pii" => "S0213005X20303177" "issn" => "0213005X" "doi" => "10.1016/j.eimc.2020.09.020" "estado" => "S300" "fechaPublicacion" => "2022-01-01" "aid" => "2312" "copyright" => "Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Enferm Infecc Microbiol Clin. 2022;40:7-13" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Original article</span>" "titulo" => "Prevalence of polypharmacy and associated factors among patients living with HIV infection in Spain: The POINT study" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "7" "paginaFinal" => "13" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Prevalencia y factores asociados a la polifarmacia en pacientes VIH+ en España. Estudio POINT" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1356 "Ancho" => 1591 "Tamanyo" => 87218 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Patterns of polypharmacy in people living with HIV in the POINT cohort. Patterns were categorized according to the type of disease they were intended to treat: cardiovascular, depression-anxiety, acute respiratory infection, chronic pulmonary disease, rhinitis-asthma, pain and menopause. The mixed pattern consisted of patients who were dispensed drugs belonging to 2 or more categories.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Ramón Morillo-Verdugo, Javier Sánchez-Rubio-Ferrández, Mercedes Gimeno-Gracia, María de las Aguas Robustillo-Cortés, Carmen V. Almeida-González" "autores" => array:6 [ 0 => array:2 [ "nombre" => "Ramón" "apellidos" => "Morillo-Verdugo" ] 1 => array:2 [ "nombre" => "Javier" "apellidos" => "Sánchez-Rubio-Ferrández" ] 2 => array:2 [ "nombre" => "Mercedes" "apellidos" => "Gimeno-Gracia" ] 3 => array:2 [ "nombre" => "María de las Aguas" "apellidos" => "Robustillo-Cortés" ] 4 => array:2 [ "nombre" => "Carmen V." "apellidos" => "Almeida-González" ] 5 => array:1 [ "colaborador" => "POINT study group" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S2529993X21002604" "doi" => "10.1016/j.eimce.2021.11.007" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2529993X21002604?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0213005X20303177?idApp=UINPBA00004N" "url" => "/0213005X/0000004000000001/v2_202112310737/S0213005X20303177/v2_202112310737/en/main.assets" ] ] "itemSiguiente" => array:18 [ "pii" => "S2529993X2100246X" "issn" => "2529993X" "doi" => "10.1016/j.eimce.2020.09.005" "estado" => "S300" "fechaPublicacion" => "2022-01-01" "aid" => "2312" "copyright" => "Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Enferm Infecc Microbiol Clin. 2022;40:7-13" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Original article</span>" "titulo" => "Prevalence of polypharmacy and associated factors among patients living with HIV infection in Spain: The POINT study" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "7" "paginaFinal" => "13" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Prevalencia y factores asociados a la polifarmacia en pacientes VIH+ en España. Estudio POINT" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0010" "etiqueta" => "Fig. 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 982 "Ancho" => 1658 "Tamanyo" => 92257 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Treatment adherence in people living with HIV in the POINT cohort. ART, antiretroviral therapy. Adherence according to dispensing information: >95% for the ART therapy and >90% for concomitant medication. Adherence according to the questionnaire: for ART therapy, the subject was not positive in the SMAQ (where positive means that there was a positive response to all of the qualitative questions of the SMAQ), no more than two doses were missed over the past week, or there were no more than 2 days of total nonmedication during the past 3 months; for the concomitant medication, a score of 4 in the Morisky-Green-Levine questionnaire. Total adherence: the subject had to meet both criteria.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Ramón Morillo-Verdugo, Javier Sánchez-Rubio-Ferrández, Mercedes Gimeno-Gracia, María de las Aguas Robustillo-Cortés, Carmen V. Almeida-González" "autores" => array:6 [ 0 => array:2 [ "nombre" => "Ramón" "apellidos" => "Morillo-Verdugo" ] 1 => array:2 [ "nombre" => "Javier" "apellidos" => "Sánchez-Rubio-Ferrández" ] 2 => array:2 [ "nombre" => "Mercedes" "apellidos" => "Gimeno-Gracia" ] 3 => array:2 [ "nombre" => "María de las Aguas" "apellidos" => "Robustillo-Cortés" ] 4 => array:2 [ "nombre" => "Carmen V." "apellidos" => "Almeida-González" ] 5 => array:1 [ "colaborador" => "POINT study group" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2529993X2100246X?idApp=UINPBA00004N" "url" => "/2529993X/0000004000000001/v1_202201040540/S2529993X2100246X/v1_202201040540/en/main.assets" ] "itemAnterior" => array:18 [ "pii" => "S2529993X21002483" "issn" => "2529993X" "doi" => "10.1016/j.eimce.2021.08.014" "estado" => "S300" "fechaPublicacion" => "2022-01-01" "aid" => "2477" "copyright" => "Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica" "documento" => "simple-article" "crossmark" => 0 "subdocumento" => "edi" "cita" => "Enferm Infecc Microbiol Clin. 2022;40:1-4" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "en" => array:10 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">EDITORIAL - SEIMC positioning</span>" "titulo" => "Justification for 24/7 clinical microbiology services" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "1" "paginaFinal" => "4" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Justificación de los servicios de microbiología clínica 24/7" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Germán Bou, Esther Calbo, Manuel Crespo, Rafael Cantón, Fran Franco Álvarez de Luna, Julio García Rodríguez, Miguel Ángel Goenaga, Juan González-García, Julià Gonzàlez, Nieves Larrosa, Luis Martínez-Martínez, David Navarro, José Ramón Paño, Antonio Rivero, Juan Carlos Rodríguez, María Tomás, Jordi Vilaj" "autores" => array:17 [ 0 => array:2 [ "nombre" => "Germán" "apellidos" => "Bou" ] 1 => array:2 [ "nombre" => "Esther" "apellidos" => "Calbo" ] 2 => array:2 [ "nombre" => "Manuel" "apellidos" => "Crespo" ] 3 => array:2 [ "nombre" => "Rafael" "apellidos" => "Cantón" ] 4 => array:2 [ "nombre" => "Fran Franco" "apellidos" => "Álvarez de Luna" ] 5 => array:2 [ "nombre" => "Julio" "apellidos" => "García Rodríguez" ] 6 => array:2 [ "nombre" => "Miguel" "apellidos" => "Ángel Goenaga" ] 7 => array:2 [ "nombre" => "Juan" "apellidos" => "González-García" ] 8 => array:2 [ "nombre" => "Julià" "apellidos" => "Gonzàlez" ] 9 => array:2 [ "nombre" => "Nieves" "apellidos" => "Larrosa" ] 10 => array:2 [ "nombre" => "Luis" "apellidos" => "Martínez-Martínez" ] 11 => array:2 [ "nombre" => "David" "apellidos" => "Navarro" ] 12 => array:2 [ "nombre" => "José" "apellidos" => "Ramón Paño" ] 13 => array:2 [ "nombre" => "Antonio" "apellidos" => "Rivero" ] 14 => array:2 [ "nombre" => "Juan" "apellidos" => "Carlos Rodríguez" ] 15 => array:2 [ "nombre" => "María" "apellidos" => "Tomás" ] 16 => array:2 [ "nombre" => "Jordi" "apellidos" => "Vilaj" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2529993X21002483?idApp=UINPBA00004N" "url" => "/2529993X/0000004000000001/v1_202201040540/S2529993X21002483/v1_202201040540/en/main.assets" ] "en" => array:12 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Editorial</span>" "titulo" => "Mind the polypharmacy in people living with HIV. A new challenge for the fourth 90" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "5" "paginaFinal" => "6" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "José R. Blanco, Jara Gallardo" "autores" => array:2 [ 0 => array:4 [ "nombre" => "José R." "apellidos" => "Blanco" "email" => array:1 [ 0 => "jrblanco@riojasalud.es" ] "referencia" => array:4 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] 2 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">1</span>" "identificador" => "fn1" ] 3 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "Jara" "apellidos" => "Gallardo" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">1</span>" "identificador" => "fn1" ] ] ] ] "afiliaciones" => array:3 [ 0 => array:3 [ "entidad" => "Servicio de Enfermedades Infecciosas. Hospital Universitario San Pedro. Logroño" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Centro de Investigación Biomédica de La Rioja" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Servicio de Farmacia Hospitalaria. Hospital Universitario San Pedro. Logroño" "etiqueta" => "c" "identificador" => "aff0015" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Atención a la polifarmacia en las personas que viven con VIH. Un nuevo reto para el cuarto 90" ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">The efficacy of antiretroviral therapy (ART) has improved the life expectancy of people living with HIV (PLWH) <a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a>. However, they experience premature aging compared to those of the same biological age who are not infected <a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a>. This leads to a higher prevalence of comorbidities, multiple physician involved in patient care and usually increasing polypharmacy <a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> with high level of medication regimen complexity. All of them are risk factors for adverse events and drug-drug interactions. ATHENA observational cohort <a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> estimates that by 2030, 84% of PLWH will have at least one non-communicable disease (NCD) and 28% three or more NCD. Related to medication, 54% will be receiving a non-HIV medication and 20% three or more non-HIV medications.</p><p id="par0010" class="elsevierStylePara elsevierViewall">In this regard, Morillo et al. <a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> analyzed not only the prevalence of polypharmacy but also the complexity of treatment in outpatient PLWH who were attended in the pharmacy services of different hospitals in Spain. The authors analyzed more than 1200 PLWH, 79% male, 47% 50 years or older, and most of them with undetectable viral load. Comorbidities were present in 67% and more than half of them had two or more comorbidities; 32.4% showed polypharmacy (defined as using 6 or more different drugs) and 5.5% major polypharmacy (11 or more different drugs).</p><p id="par0015" class="elsevierStylePara elsevierViewall">The data reported by Morillo et al. <a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> also reflect the growing concern in the average of drugs and complexity of overall pharmacotherapy in PLWH and the need to optimize it. We are used to think about polypharmacy in a quantitative way, based on the number of drugs prescribed. However, a much more qualitative analysis is important, since other conditioning factors such as administration patterns, pharmaceutical forms, etc. contribute to difficult adherence. To address this problem, the Medication Regimen Complexity Index (MRCI) <a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a> was developed. In recent years, multiple articles focus on HIV infection has been published <a class="elsevierStyleCrossRefs" href="#bib0035"><span class="elsevierStyleSup">7–9</span></a> noting, among others, that total non-adherence to treatment was an independent factor associated with a higher MRCI. This situation is further complicated, as Manzano-García et al. pointed out <a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a>, by incorporating a new concept such as pharmacotherapeutic complexity that would include not only the MRCI score but also the score perceived by the own patients (i.e. through the visual analog scales). Given the importance of pharmacotherapeutic optimization, and in order to transfer it to daily clinical practice, it would be necessary to establish new lines of research based on multidisciplinary coordination and the use of new technologies for patient follow-up.</p><p id="par0020" class="elsevierStylePara elsevierViewall">Polypharmacy does not always imply inappropriate treatment, but sometimes it brings several challenges, as dealing with significative negative effects for the patient and the health-care system (loss of adherence to ART, cognitive impairment, hospitalization and mortality…) <a class="elsevierStyleCrossRefs" href="#bib0050"><span class="elsevierStyleSup">10–12</span></a>, or increasing the risk of prescribing drugs to treat adverse effects of established treatments (prescribing cascade) <a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">13</span></a>. Many of these adverse events could be potentially preventable. For this reason, reconciliation, prioritization and ensuring the correct use of the pharmacotherapy should be a priority and part of routine clinical practice focused on preventing unnecessary polypharmacy. In this context, specific guidelines <a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">14</span></a> and tools have been developed to identify potentially inappropriate prescriptions (Beers Criteria, STOPP / START tool, anticholinergic load scale...) <a class="elsevierStyleCrossRefs" href="#bib0075"><span class="elsevierStyleSup">15–17</span></a> to prioritize the most dangerous ones. Therefore, efforts will focus on those in which they are specifically contraindicated <a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a>. Special mention should be made of anticholinergics <a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">18</span></a> and opioids for the treatment of chronic pain <a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">19</span></a>. The EACS guideline has included a “Selected Top 10 Drug Classes to Avoid in Older PLWH” because of the problems they can cause in this population. The list included first-generation antihistamines, tricyclic antidepressants, benzodiazepines, atypical antipsychotics, urological spasmolytic agents, laxatives, stimulant laxatives, non-steroidal anti-inflammatory drugs, digoxin (dosage >0.125<span class="elsevierStyleHsp" style=""></span>mg/day), long-acting sulfonylureas and cold medicines <a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">20</span></a>. However, in a small study carried out by Contreras-Macías et al. <a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a> in PLWH aged 65 years or older, and having into account the previous list, a potential inappropriate prescription was identified in 47.4%.</p><p id="par0025" class="elsevierStylePara elsevierViewall">In Spain, specialized clinical pharmacists and primary care services should be provided with the tools necessary for deprescribing and eliminate potential barriers to their application (time constraints, complexity of the approach that affects different specialties, communicational barriers…). Overcoming these barriers and being proactive on deprescription could help on many levels providing clear health benefit to these people. In fact, comorbility and polypharmacy are included yet in the stratification scores of PLWH <a class="elsevierStyleCrossRefs" href="#bib0105"><span class="elsevierStyleSup">21,22</span></a>.</p><p id="par0030" class="elsevierStylePara elsevierViewall">As a take-home message, no more “missed opportunities”, so the suitability of drug therapy should be periodically evaluated to assess the adequacy of pharmacotherapy. This is not only a drug burden problem, but also an overall health improvement issue.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:3 [ "etiqueta" => "1" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Both authors contributed equally.</p>" "identificador" => "fn1" ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:22 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Life expectancy in HIV-positive persons in Switzerland: matched comparison with general population" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "A. Gueler" 1 => "A. Moser" 2 => "A. Calmy" 3 => "H.F. Günthard" 4 => "E. Bernasconi" 5 => "H. Furrer" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/QAD.0000000000001335" "Revista" => array:6 [ "tituloSerie" => "AIDS." "fecha" => "2017" "volumen" => "31" "paginaInicial" => "427" "paginaFinal" => "436" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27831953" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Inflammation-related genes are associated with epigenetic aging in HIV" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "E.E. Sundermann" 1 => "M.A. Hussain" 2 => "D.J. Moore" 3 => "S. Horvath" 4 => "D.T.S. Lin" 5 => "M.S. Kobor" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s13365-019-00777-4" "Revista" => array:6 [ "tituloSerie" => "J Neurovirol." "fecha" => "2019" "volumen" => "25" "paginaInicial" => "853" "paginaFinal" => "865" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/31286441" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Polypharmacy and drug-drug interactions in people living with human immunodeficiency virus in the region of Madrid" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "B. López-Centeno" 1 => "C. Badenes-Olmedo" 2 => "Á. Mataix-Sanjuan" 3 => "K. McAllister" 4 => "J.M. Bellón" 5 => "S. Gibbons" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1093/cid/ciz811" "Revista" => array:6 [ "tituloSerie" => "Spain: a population-based study. Clin Infect Dis." "fecha" => "2020" "volumen" => "71" "paginaInicial" => "353" "paginaFinal" => "362" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/31428770" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0020" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Future challenges for clinical care of an ageing population infected with HIV: a modelling study" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "M. Smit" 1 => "K. Brinkman" 2 => "S. Geerlings" 3 => "C. Smit" 4 => "K. Thyagarajan" 5 => "Sighem Av" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/S1473-3099(15)00056-0" "Revista" => array:6 [ "tituloSerie" => "Lancet Infect Dis." "fecha" => "2015" "volumen" => "15" "paginaInicial" => "810" "paginaFinal" => "818" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26070969" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0025" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Prevalence of polypharmacy and associated factors among patients living with HIV infection in Spain: The POINT study" "autores" => array:1 [ 0 => array:3 [ "colaboracion" => "POINT study group." "etal" => false "autores" => array:5 [ 0 => "R. Morillo-Verdugo" 1 => "J. Sánchez-Rubio-Ferrández" 2 => "M. Gimeno-Gracia" 3 => "M.A. Robustillo-Cortés" 4 => "C.V. Almeida-González" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Enferm Infecc Microbiol Clin." "fecha" => "2022" "volumen" => "40" "paginaInicial" => "7" "paginaFinal" => "13" ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0030" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Development and validation of the medication regimen complexity index" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "J. George" 1 => "Y.T. Phun" 2 => "M.J. Bailey" 3 => "D.C. Kong" 4 => "K. Stewart" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1345/aph.1D479" "Revista" => array:6 [ "tituloSerie" => "Ann Pharmacother." "fecha" => "2004" "volumen" => "38" "paginaInicial" => "1369" "paginaFinal" => "1376" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15266038" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0035" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Determination of a cutoff value for medication regimen complexity index to predict polypharmacy in HIV+ older patient" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "R. Morillo-Verdugo" 1 => "M.A. Robustillo-Cortés" 2 => "L. Abdel-Kader Martín" 3 => "M. Álvarez de Sotomayor Paz" 4 => "F. Lozano de León Naranjo" 5 => "C.V. Almeida González" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Rev Esp Quimioter." "fecha" => "2019" "volumen" => "32" "paginaInicial" => "458" "paginaFinal" => "464" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/31528986" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0040" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Concordance between pharmacotherapeutic complexity calculated and perceived by HIV+ patients with antiretroviral treatment" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "M. Manzano-García" 1 => "R. Serrano-Giménez" 2 => "M.L.A. Robustillo-Cortés" 3 => "R. Morillo-Verdugo" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.7399/fh.11121" "Revista" => array:6 [ "tituloSerie" => "Farm Hosp." "fecha" => "2019" "volumen" => "43" "paginaInicial" => "31" "paginaFinal" => "35" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30624171" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0045" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "High level of medication regimen complexity index correlate with worse quality of life in people living with HIV" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "E. Contreras-Macías" 1 => "A. Gutiérrez-Pizarraya" 2 => "M.A. Robustillo-Cortés" 3 => "R. Morillo-Verdugo" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.37201/req/097.2020" "Revista" => array:6 [ "tituloSerie" => "Rev Esp Quimioter." "fecha" => "2021" "volumen" => "34" "paginaInicial" => "93" "paginaFinal" => "99" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/33499583" "web" => "Medline" ] ] ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0050" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Clinical consequences of polypharmacy in elderly: expect the unexpected, think the unthinkable" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "J.A. Salazar" 1 => "I. Poon" 2 => "M. Nair" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1517/14740338.6.6.695" "Revista" => array:6 [ "tituloSerie" => "Expert Opin Drug Saf." "fecha" => "2007" "volumen" => "6" "paginaInicial" => "695" "paginaFinal" => "704" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17967158" "web" => "Medline" ] ] ] ] ] ] ] ] 10 => array:3 [ "identificador" => "bib0055" "etiqueta" => "11" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Health outcomes associated with polypharmacy in community-dwelling older adults: a systematic review" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "T.R. Fried" 1 => "J. O’Leary" 2 => "V. Towle" 3 => "M.K. Goldstein" 4 => "M. Trentalange" 5 => "D.K. Martin" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/jgs.13153" "Revista" => array:6 [ "tituloSerie" => "J Am Geriatr Soc." "fecha" => "2014" "volumen" => "62" "paginaInicial" => "2261" "paginaFinal" => "2272" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25516023" "web" => "Medline" ] ] ] ] ] ] ] ] 11 => array:3 [ "identificador" => "bib0060" "etiqueta" => "12" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Polypharmacy, adverse drug reactions, and geriatric syndromes" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "B.M. Shah" 1 => "E.R. Hajjar" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.cger.2012.01.002" "Revista" => array:6 [ "tituloSerie" => "Clin Geriatr Med." "fecha" => "2012" "volumen" => "28" "paginaInicial" => "173" "paginaFinal" => "186" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22500537" "web" => "Medline" ] ] ] ] ] ] ] ] 12 => array:3 [ "identificador" => "bib0065" "etiqueta" => "13" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Using a clinical process map to identify prescribing cascades in your patient" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "K.L. Piggott" 1 => "N. Mehta" 2 => "C.L. Wong" 3 => "P.A. Rochon" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1136/bmj.m261" "Revista" => array:5 [ "tituloSerie" => "BMJ." "fecha" => "2020" "volumen" => "368" "paginaInicial" => "m261" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/32075785" "web" => "Medline" ] ] ] ] ] ] ] ] 13 => array:3 [ "identificador" => "bib0070" "etiqueta" => "14" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Deprescribing of non-antiretroviral therapy in HIV-infected patients" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J.R. Blanco" 1 => "R. Morillo" 2 => "V. Abril" 3 => "I. Escobar" 4 => "E. Bernal" 5 => "C. Folguera" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s00228-019-02785-z" "Revista" => array:6 [ "tituloSerie" => "Eur J Clin Pharmacol." "fecha" => "2020" "volumen" => "76" "paginaInicial" => "305" "paginaFinal" => "318" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/31865412" "web" => "Medline" ] ] ] ] ] ] ] ] 14 => array:3 [ "identificador" => "bib0075" "etiqueta" => "15" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "STOPP (Screening Tool of Older Person's Prescriptions) and START (Screening Tool to Alert doctors to Right Treatment)" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "P. Gallagher" 1 => "C. Ryan" 2 => "S. Byrne" 3 => "J. Kennedy" 4 => "D. O’Mahony" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.5414/cpp46072" "Revista" => array:6 [ "tituloSerie" => "Consensus validation. Int J Clin Pharmacol Ther." "fecha" => "2008" "volumen" => "46" "paginaInicial" => "72" "paginaFinal" => "83" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18218287" "web" => "Medline" ] ] ] ] ] ] ] ] 15 => array:3 [ "identificador" => "bib0080" "etiqueta" => "16" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Explicit criteria for determining inappropriate medication use in nursing home residents. UCLA Division of Geriatric Medicine" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "M.H. Beers" 1 => "J.G. Ouslander" 2 => "I. Rollingher" 3 => "D.B. Reuben" 4 => "J. Brooks" 5 => "J.C. Beck" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Arch Intern Med." "fecha" => "1991" "volumen" => "151" "paginaInicial" => "1825" "paginaFinal" => "1832" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1888249" "web" => "Medline" ] ] ] ] ] ] ] ] 16 => array:3 [ "identificador" => "bib0085" "etiqueta" => "17" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Anticholinergic burden quantified by anticholinergic risk scales and adverse outcomes in older people: a systematic review" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "M.S. Salahudeen" 1 => "S.B. Duffull" 2 => "P.S. Nishtala" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1186/s12877-015-0029-9" "Revista" => array:5 [ "tituloSerie" => "BMC Geriatr." "fecha" => "2015" "volumen" => "15" "paginaInicial" => "31" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25879993" "web" => "Medline" ] ] ] ] ] ] ] ] 17 => array:3 [ "identificador" => "bib0090" "etiqueta" => "18" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Effects of anticholinergic medication use on brain integrity in persons living with HIV and persons without HIV" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "S.A. Cooley" 1 => "R.H. Paul" 2 => "J.F. Strain" 3 => "A. Boerwinkle" 4 => "C. Kilgore" 5 => "B.M. Ances" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/QAD.0000000000002768" "Revista" => array:6 [ "tituloSerie" => "AIDS." "fecha" => "2021" "volumen" => "35" "paginaInicial" => "381" "paginaFinal" => "391" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/33252494" "web" => "Medline" ] ] ] ] ] ] ] ] 18 => array:3 [ "identificador" => "bib0095" "etiqueta" => "19" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Chronic high risk prescription opioid use among persons with HIV" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "A. Ventuneac" 1 => "G. Hecht" 2 => "E. Forcht" 3 => "B.A. Duah" 4 => "S. Tarar" 5 => "B. Langenbach" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.3389/fsoc.2021.645992" "Revista" => array:5 [ "tituloSerie" => "Front Sociol." "fecha" => "2021" "volumen" => "6" "paginaInicial" => "645992" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/34095287" "web" => "Medline" ] ] ] ] ] ] ] ] 19 => array:3 [ "identificador" => "bib0100" "etiqueta" => "20" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "Selected Top 10 Drug Classes to Avoid in Older PLWHA. In: EACS Guidelines version 11.0 (October 2021). Available at: https://www.eacsociety.org/media/final2021eacsguidelinesv11.0_oct2021.pdf." ] ] ] 20 => array:3 [ "identificador" => "bib0105" "etiqueta" => "21" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Development of a risk stratification model for pharmaceutical care in HIV patients" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "R. Morillo-Verdugo" 1 => "J.M. Martínez-Sesmero" 2 => "A. Lázaro-López" 3 => "J. Sánchez-Rubio" 4 => "H. Navarro-Aznárez" 5 => "M. de Miguel-Cascón" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.7399/fh.2017.41.3.10655" "Revista" => array:6 [ "tituloSerie" => "Farm Hosp." "fecha" => "2017" "volumen" => "41" "paginaInicial" => "346" "paginaFinal" => "356" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28478749" "web" => "Medline" ] ] ] ] ] ] ] ] 21 => array:3 [ "identificador" => "bib0110" "etiqueta" => "22" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "Mora J, Rojo A, Arratibel P, Bengoa R y Grupo Multidisciplinar de Expertos en VIH. Sistema de estratificación de pacientes con VIH. The Institute for Health and Strategy (SI-Health). 2020. Available at: https://gesida-seimc.org/wp-content/uploads/2020/11/InformeHerramientasEstratificacion.pdf." ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/2529993X/0000004000000001/v1_202201040540/S2529993X21002604/v1_202201040540/en/main.assets" "Apartado" => array:4 [ "identificador" => "64518" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Editorial" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/2529993X/0000004000000001/v1_202201040540/S2529993X21002604/v1_202201040540/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2529993X21002604?idApp=UINPBA00004N" ]
| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 3 | 1 | 4 |
| 2024 October | 17 | 5 | 22 |
| 2024 September | 26 | 2 | 28 |
| 2024 August | 20 | 5 | 25 |
| 2024 July | 12 | 6 | 18 |
| 2024 June | 20 | 4 | 24 |
| 2024 May | 12 | 3 | 15 |
| 2024 April | 20 | 3 | 23 |
| 2024 March | 17 | 1 | 18 |
| 2024 February | 9 | 5 | 14 |
| 2024 January | 26 | 3 | 29 |
| 2023 December | 19 | 3 | 22 |
| 2023 November | 18 | 6 | 24 |
| 2023 October | 21 | 5 | 26 |
| 2023 September | 28 | 5 | 33 |
| 2023 August | 14 | 3 | 17 |
| 2023 July | 14 | 2 | 16 |
| 2023 June | 24 | 0 | 24 |
| 2023 May | 42 | 2 | 44 |
| 2023 April | 48 | 0 | 48 |
| 2023 March | 30 | 6 | 36 |
| 2023 February | 15 | 1 | 16 |
| 2023 January | 2 | 2 | 4 |
| 2022 December | 9 | 10 | 19 |
| 2022 November | 13 | 5 | 18 |
| 2022 October | 11 | 3 | 14 |
| 2022 September | 9 | 11 | 20 |
| 2022 August | 10 | 5 | 15 |
| 2022 July | 13 | 5 | 18 |
| 2022 February | 6 | 0 | 6 |
Show all
