323. Comorbidity Prevalence and its Influence on Non-ARV Comedication Burden among HIV positive Patients
Session: Poster Abstract Session: HIV Co-morbidities
Thursday, October 3, 2013
Room: The Moscone Center: Poster Hall C
Posters
  • HIV pill burden comorbidities_final_IDWeek 2013.pdf (110.6 kB)
  • Background:

    Accelerated aging associated with HIV and higher comorbidity prevalence have increased non-antiretroviral (ARV) comedication burden for HIV positive (HIV+) people.

    Methods:

    We compared comorbidity prevalence and non-ARV drug burden, over a 12-month period, among age and gender matched HIV+ and negative (HIV-) patients aged 18-49 and ≥50 years using a comprehensive, de-identified US healthcare claims database (Optum™ Impact™ National Managed Care Benchmark Database).

    Results:

    We identified 15811 HIV+ patients aged 18-49 years and 47433 matched controls; 7529 HIV+ patients ≥ aged 50 years and 22587 matched controls. For HIV+ patients aged 18-49, 72% were male; 57% received antiretroviral therapy (ART); 63% had ≥1 comorbidities (controls: 42%), 28% had 1 only, 26% had 2-3, 7% had 4-5, 2% had >5. For HIV+patients aged ≥50, 79% were male; 66% received ART; 83% had ≥1 comorbidities (controls: 69%), 22% had 1 only, 36% had 2-3, 15% had 4-5, 10% had >5.  

    For patients aged 18-49 years, cases were prescribed a mean of 4.8 (±4.5) drug classes over a year [controls: 2.9 (±3.5); p<0.0001].  Cases were also prescribed a median of 4 [interquartile range (IQR): 1-7] non-ARV unique drugs [controls: 2 (IQR: 0-4)]; 35% of cases were prescribed >5 unique drugs (controls: 19%). For those aged ≥50, cases were prescribed a mean of 6.9 (±5.6) drug classes [controls: 4.6 (±4.5); p<0.0001]. Cases were also prescribed a median of 6 (IQR: 3-10) drugs [controls: 3 (IQR: 1-7)]; 54% of cases were prescribed >5 unique drugs (controls: 34%).

    For HIV+ patients aged ≥50 years, 40% of those with 1 comorbidity only were prescribed >5 non-ARV unique drugs.  For those with 2-3 comorbidities, 57% were prescribed >5 drugs; for those with 4-5, 78% were prescribed >5 drugs; for those with >5, 90% were prescribed >5 drugs. For HIV+patients aged 18-49 years, 33% with 1 comorbidity only were prescribed >5 non-ARV unique drugs; 50% of those with 2-3 comorbidities were prescribed >5; 70% of those with 4-5 comorbidities were prescribed >5; 82% with >5 comorbidities were prescribed >5.

    Conclusion:

    Compared to controls, HIV+ patients were more likely to have ≥1 comorbidities, were prescribed significantly higher numbers of non-ARV unique drugs and classes of drugs, and were more likely to be prescribed >5 non-ARV unique drugs. The number of comorbidities was linearly associated with the number of non-ARV unique drugs prescribed.

    Nana Koram, MPH, PhD1, Vani Vannappagari, MBBS, MPH, PhD1,2, Tim Sampson, BSc (Hons)3 and Catherine Panozzo, MPH2,4, (1)Worldwide Epidemiology, Glaxosmithkline, Research Triangle Park, NC, (2)Gillings School of Global Public Health, University of North Carolina-Chapel Hill, Chapel Hill, NC, (3)Observational Data Analytics, Glaxosmithkline, Research Triangle Park, NC, (4)Global Pharmacovigilance, Sanofi Pasteur, Swiftwater, PA

    Disclosures:

    N. Koram, None

    V. Vannappagari, None

    T. Sampson, None

    C. Panozzo, None

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