Polypharmacy, Drug-Drug Interactions, and Potentially Inappropriate Medications in Older Adults with Human Immunodeficiency Virus Infection

Objectives To describe the frequency of medication‐related problems in older adults with human immunodeficiency virus (HIV) infection. Design Retrospective chart review. Setting Community. Participants HIV‐positive individuals aged 60 and older and age‐ and sex‐matched HIV‐negative individuals. Measurements Total number of medications, potentially inappropriate medications (PIMs) according to the modified Beers Criteria, anticholinergic drug burden according to the Anticholinergic Risk Scale (ARS), and drug–drug interactions using the Lexi‐Interact online drug interactions database. Results Of 89 HIV‐positive participants, most were Caucasian (91%) and male (94%), with a median age of 64 (range 60–82). Common comorbidities included hyperlipidemia, hypertension, and depression. Participants were taking a median of 13 medications (range 2–38), of which only a median of four were antiretrovirals. At least one PIM was prescribed in 46 participants (52%). Sixty‐two (70%) participants had at least one Category D (consider therapy modification) drug–drug interaction, and 10 (11%) had a Category X (avoid combination) interaction. One‐third of these interactions were between two nonantiretroviral medications. Fifteen participants (17%) had an ARS score of 3 or greater. In contrast, HIV‐negative participants were taking a median of six medications, 29% had at least one PIM, and 4% had an ARS score of 3 or greater (P