Determination of a Cutoff Value for Medication Regimen Complexity Index to Predict Polypharmacy in HIV+ Older Patient
Introduction. HIV+ patients have increased their life expectancy with a parallel increase in age-associated co-morbidities and pharmacotherapeutic complexity. The aim of this study was to determine an optimal cutoff value for Medication regimen complexity index (MRCI) to predict polypharmacy in HIV+...
| Autores: | , , , , , |
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| Tipo de recurso: | artículo |
| Estado: | Versión publicada |
| Fecha de publicación: | 2019 |
| País: | España |
| Institución: | Universidad de Sevilla (US) |
| Repositorio: | idUS. Depósito de Investigación de la Universidad de Sevilla |
| OAI Identifier: | oai:idus.us.es:11441/172448 |
| Acceso en línea: | https://hdl.handle.net/11441/172448 |
| Access Level: | acceso abierto |
| Palabra clave: | Aging HIV Pharmacotherapy complexity Polypharmacy VIH Polifarmacia Complejidad farmacoterapéutica Envejecimiento |
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España |
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Determination of a Cutoff Value for Medication Regimen Complexity Index to Predict Polypharmacy in HIV+ Older Patient Determinación del valor umbral del índice de complejidad de la farmacoterapia para predecir polifarmacia en pacientes VIH+ |
| title |
Determination of a Cutoff Value for Medication Regimen Complexity Index to Predict Polypharmacy in HIV+ Older Patient |
| spellingShingle |
Determination of a Cutoff Value for Medication Regimen Complexity Index to Predict Polypharmacy in HIV+ Older Patient Morillo Verdugo, Ramón Alejandro Aging HIV Pharmacotherapy complexity Polypharmacy VIH Polifarmacia Complejidad farmacoterapéutica Envejecimiento |
| title_short |
Determination of a Cutoff Value for Medication Regimen Complexity Index to Predict Polypharmacy in HIV+ Older Patient |
| title_full |
Determination of a Cutoff Value for Medication Regimen Complexity Index to Predict Polypharmacy in HIV+ Older Patient |
| title_fullStr |
Determination of a Cutoff Value for Medication Regimen Complexity Index to Predict Polypharmacy in HIV+ Older Patient |
| title_full_unstemmed |
Determination of a Cutoff Value for Medication Regimen Complexity Index to Predict Polypharmacy in HIV+ Older Patient |
| title_sort |
Determination of a Cutoff Value for Medication Regimen Complexity Index to Predict Polypharmacy in HIV+ Older Patient |
| dc.creator.none.fl_str_mv |
Morillo Verdugo, Ramón Alejandro Robustillo Cortés, María de las Aguas Abdel-Kader Martín, Laila Álvarez de Sotomayor Paz, María Lozano de León Naranjo, Fernando Almeida González, Carmen V. |
| author |
Morillo Verdugo, Ramón Alejandro |
| author_facet |
Morillo Verdugo, Ramón Alejandro Robustillo Cortés, María de las Aguas Abdel-Kader Martín, Laila Álvarez de Sotomayor Paz, María Lozano de León Naranjo, Fernando Almeida González, Carmen V. |
| author_role |
author |
| author2 |
Robustillo Cortés, María de las Aguas Abdel-Kader Martín, Laila Álvarez de Sotomayor Paz, María Lozano de León Naranjo, Fernando Almeida González, Carmen V. |
| author2_role |
author author author author author |
| dc.contributor.none.fl_str_mv |
Farmacología |
| dc.subject.none.fl_str_mv |
Aging HIV Pharmacotherapy complexity Polypharmacy VIH Polifarmacia Complejidad farmacoterapéutica Envejecimiento |
| topic |
Aging HIV Pharmacotherapy complexity Polypharmacy VIH Polifarmacia Complejidad farmacoterapéutica Envejecimiento |
| description |
Introduction. HIV+ patients have increased their life expectancy with a parallel increase in age-associated co-morbidities and pharmacotherapeutic complexity. The aim of this study was to determine an optimal cutoff value for Medication regimen complexity index (MRCI) to predict polypharmacy in HIV+ older patients Patients and methods. A transversal observational single cohort study was conducted at a tertiary Hospital in Spain, between January 1st up to December 31st, 2014. Patients included were HIV patients over 50 years of age on active antiretroviral treatment. Prevalence of polypharmacy and it pattern were analyzed. The pharmacotherapy complexity value was calculated through the MRCI. Receiver operating characteristic curve analyses were used to calculate the area under the curve (AUC) for the MRCI value medications to determine the best cutoff value for identifying outcomes including polypharmacy. Sensitivity and specificity were also calculated. Results. A total of 223 patients were included. A 56.1% of patients had polypharmacy, being extreme polypharmacy in 9.4% of cases. Regarding the pattern of polypharmacy, 78.0% had a cardio-metabolic pattern, 12.0% depressive-psychogeriatric, 8.0% mixed and 2.0% mechanical-thyroidal. The ROC curve demonstrated that a value of medication complexity index of 11.25 point was the best cutoff for predict polypharmacy (AUC=0.931; sensitivity= 77.6%; specificity= 91.8%). Conclusions. A cut-off value of 11.25 for MRCI is proposed to determine if a patient reaches the criterion of polypharmacy. In conclusion, the concept of polypharmacy should include not only the number of prescribed drugs but also the complexity of them. |
| publishDate |
2019 |
| dc.date.none.fl_str_mv |
2019 |
| dc.type.none.fl_str_mv |
info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion |
| format |
article |
| status_str |
publishedVersion |
| dc.identifier.none.fl_str_mv |
https://hdl.handle.net/11441/172448 |
| url |
https://hdl.handle.net/11441/172448 |
| dc.language.none.fl_str_mv |
Inglés |
| language_invalid_str_mv |
Inglés |
| dc.relation.none.fl_str_mv |
Revista Española de Quimioterapia, 32 (5), 458-464. |
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info:eu-repo/semantics/openAccess |
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openAccess |
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application/pdf application/pdf |
| dc.publisher.none.fl_str_mv |
Sociedad Española de Quiminoterapia |
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Sociedad Española de Quiminoterapia |
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reponame:idUS. Depósito de Investigación de la Universidad de Sevilla instname:Universidad de Sevilla (US) |
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Universidad de Sevilla (US) |
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idUS. Depósito de Investigación de la Universidad de Sevilla |
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idUS. Depósito de Investigación de la Universidad de Sevilla |
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1869405259826200576 |
| spelling |
Determination of a Cutoff Value for Medication Regimen Complexity Index to Predict Polypharmacy in HIV+ Older PatientDeterminación del valor umbral del índice de complejidad de la farmacoterapia para predecir polifarmacia en pacientes VIH+Morillo Verdugo, Ramón AlejandroRobustillo Cortés, María de las AguasAbdel-Kader Martín, LailaÁlvarez de Sotomayor Paz, MaríaLozano de León Naranjo, FernandoAlmeida González, Carmen V.AgingHIVPharmacotherapy complexityPolypharmacyVIHPolifarmaciaComplejidad farmacoterapéuticaEnvejecimientoIntroduction. HIV+ patients have increased their life expectancy with a parallel increase in age-associated co-morbidities and pharmacotherapeutic complexity. The aim of this study was to determine an optimal cutoff value for Medication regimen complexity index (MRCI) to predict polypharmacy in HIV+ older patients Patients and methods. A transversal observational single cohort study was conducted at a tertiary Hospital in Spain, between January 1st up to December 31st, 2014. Patients included were HIV patients over 50 years of age on active antiretroviral treatment. Prevalence of polypharmacy and it pattern were analyzed. The pharmacotherapy complexity value was calculated through the MRCI. Receiver operating characteristic curve analyses were used to calculate the area under the curve (AUC) for the MRCI value medications to determine the best cutoff value for identifying outcomes including polypharmacy. Sensitivity and specificity were also calculated. Results. A total of 223 patients were included. A 56.1% of patients had polypharmacy, being extreme polypharmacy in 9.4% of cases. Regarding the pattern of polypharmacy, 78.0% had a cardio-metabolic pattern, 12.0% depressive-psychogeriatric, 8.0% mixed and 2.0% mechanical-thyroidal. The ROC curve demonstrated that a value of medication complexity index of 11.25 point was the best cutoff for predict polypharmacy (AUC=0.931; sensitivity= 77.6%; specificity= 91.8%). Conclusions. A cut-off value of 11.25 for MRCI is proposed to determine if a patient reaches the criterion of polypharmacy. In conclusion, the concept of polypharmacy should include not only the number of prescribed drugs but also the complexity of them.Introducción. La esperanza de vida de los pacientes VIH+ se ha incrementado. De forma paralela han aumentado las comorbilidades asociadas a la edad y la complejidad farmacoterapéutica. El objetivo del estudio es estimar el valor umbral del índice de complejidad de la farmacoterapia (MRCI) para la determinación del criterio de polifarmacia en pacientes VIH+ mayores de 50 años. Métodos. Estudio observacional, trasversal, unicéntrico. Se incluyeron todos los pacientes VIH+ mayores de 50 años, en tratamiento antirretroviral activo entre el 1 enero y 31 diciembre-2015. Se determinó la presencia de polifarmacia y los patrones asociados. La complejidad del tratamiento se calculó con la herramienta MRCI (Universidad de Colorado). Se analizó el índice de complejidad total como marcador cuantitativo de polifarmacia mediante la realización de una curva ROC y el cálculo de su área bajo la curva. Se calculó la sensibilidad y la especificidad de la misma. Resultados. Se incluyeron 223 pacientes. El 56,1% presentó polifarmacia, siendo extrema en el 9,4% de los casos. En relación con el patrón de polifarmacia, el 78,0% presentaron un patrón cardio-metabólico, el 12,0% psico geriátrico-depresivo, el 8,0% mixto y el 2,0% mecánico tiroideo .Se determinó un valor de área bajo la curva ROC de 0,931 con límites entre (0,901-0,962) y p< 0,001. El valor 11,25 de índice de complejidad total de la farmacoterapia proporcionó un valor de especificidad del 92% y una sensibilidad del 78%. Conclusión. El valor de 11,25 de índice de complejidad es un buen indicador para conocer los pacientes con polifarmacia. El concepto de polifarmacia no solo debe incluir el número de fármacos que toma el paciente sino incluir también la complejidad del tratamiento.Sociedad Española de QuiminoterapiaFarmacología2019info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfapplication/pdfhttps://hdl.handle.net/11441/172448reponame:idUS. Depósito de Investigación de la Universidad de Sevillainstname:Universidad de Sevilla (US)InglésRevista Española de Quimioterapia, 32 (5), 458-464.info:eu-repo/semantics/openAccessoai:idus.us.es:11441/1724482026-06-17T12:51:07Z |
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15.812429 |