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HIV treatment regimens and adherence to national guidelines in Australia: an analysis of dispensing data from the Australian pharmaceutical benefits scheme
BACKGROUND: Treatment guidelines for antiretroviral therapy (ART) have evolved to emphasize newer regimens that address ageing-related comorbidities. Using national Australian dispensing data we compare ART regimens with Australian HIV treatment guidelines in the context of treated comorbidities. ME...
Autores principales: | , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6318998/ https://www.ncbi.nlm.nih.gov/pubmed/30606134 http://dx.doi.org/10.1186/s12889-018-6325-5 |
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author | Dharan, Nila J. Radovich, Tomas Che, Samuel Petoumenos, Kathy Juneja, Prabhjot Law, Matthew Huang, Robin McManus, Hamish Polizzotto, Mark N. Guy, Rebecca Cronin, Peter Cooper, David A. Gray, Richard T. |
author_facet | Dharan, Nila J. Radovich, Tomas Che, Samuel Petoumenos, Kathy Juneja, Prabhjot Law, Matthew Huang, Robin McManus, Hamish Polizzotto, Mark N. Guy, Rebecca Cronin, Peter Cooper, David A. Gray, Richard T. |
author_sort | Dharan, Nila J. |
collection | PubMed |
description | BACKGROUND: Treatment guidelines for antiretroviral therapy (ART) have evolved to emphasize newer regimens that address ageing-related comorbidities. Using national Australian dispensing data we compare ART regimens with Australian HIV treatment guidelines in the context of treated comorbidities. METHODS: The study population included all individuals in a 10% sample of national data from the Australian Pharmaceutical Benefits Scheme (PBS) who purchased a prescription of ART during 2016. We defined each patient’s most recently dispensed ART regimen and characterized them to evaluate regimen complexity and adherence to national HIV treatment guidelines. We then analyzed ART regimens in the context of other co-prescriptions purchased for defined comorbidities. RESULTS: The 1995 patients in our sample purchased 212 different ART regimens during 2016; 1524 (76.4%) purchased one of the top ten most common regimens of which 62.3% were integrase strand transfer inhibitor-based. Among the 1786 (90%) patients that purchased the most common regimens, 83.7% purchased a regimen recommended by the guidelines for initial antiretroviral therapy and 11.4% purchased antiretrovirals that are not recommended for initial therapy; < 1% of the entire cohort purchased medications not recommended for use. While most patients purchased optimal ART regimens with low potential for significant drug interactions, regimen choices in the setting of risk factors for heart disease, renal disease and low bone mineral density appeared suboptimal. CONCLUSIONS: Australian HIV providers are prescribing ART regimens in accordance with updated treatment guidelines, but could further optimize regimens in the setting of important medical comorbidities. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12889-018-6325-5) contains supplementary material, which is available to authorized users. |
format | Online Article Text |
id | pubmed-6318998 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-63189982019-01-08 HIV treatment regimens and adherence to national guidelines in Australia: an analysis of dispensing data from the Australian pharmaceutical benefits scheme Dharan, Nila J. Radovich, Tomas Che, Samuel Petoumenos, Kathy Juneja, Prabhjot Law, Matthew Huang, Robin McManus, Hamish Polizzotto, Mark N. Guy, Rebecca Cronin, Peter Cooper, David A. Gray, Richard T. BMC Public Health Research Article BACKGROUND: Treatment guidelines for antiretroviral therapy (ART) have evolved to emphasize newer regimens that address ageing-related comorbidities. Using national Australian dispensing data we compare ART regimens with Australian HIV treatment guidelines in the context of treated comorbidities. METHODS: The study population included all individuals in a 10% sample of national data from the Australian Pharmaceutical Benefits Scheme (PBS) who purchased a prescription of ART during 2016. We defined each patient’s most recently dispensed ART regimen and characterized them to evaluate regimen complexity and adherence to national HIV treatment guidelines. We then analyzed ART regimens in the context of other co-prescriptions purchased for defined comorbidities. RESULTS: The 1995 patients in our sample purchased 212 different ART regimens during 2016; 1524 (76.4%) purchased one of the top ten most common regimens of which 62.3% were integrase strand transfer inhibitor-based. Among the 1786 (90%) patients that purchased the most common regimens, 83.7% purchased a regimen recommended by the guidelines for initial antiretroviral therapy and 11.4% purchased antiretrovirals that are not recommended for initial therapy; < 1% of the entire cohort purchased medications not recommended for use. While most patients purchased optimal ART regimens with low potential for significant drug interactions, regimen choices in the setting of risk factors for heart disease, renal disease and low bone mineral density appeared suboptimal. CONCLUSIONS: Australian HIV providers are prescribing ART regimens in accordance with updated treatment guidelines, but could further optimize regimens in the setting of important medical comorbidities. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12889-018-6325-5) contains supplementary material, which is available to authorized users. BioMed Central 2019-01-03 /pmc/articles/PMC6318998/ /pubmed/30606134 http://dx.doi.org/10.1186/s12889-018-6325-5 Text en © The Author(s). 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Article Dharan, Nila J. Radovich, Tomas Che, Samuel Petoumenos, Kathy Juneja, Prabhjot Law, Matthew Huang, Robin McManus, Hamish Polizzotto, Mark N. Guy, Rebecca Cronin, Peter Cooper, David A. Gray, Richard T. HIV treatment regimens and adherence to national guidelines in Australia: an analysis of dispensing data from the Australian pharmaceutical benefits scheme |
title | HIV treatment regimens and adherence to national guidelines in Australia: an analysis of dispensing data from the Australian pharmaceutical benefits scheme |
title_full | HIV treatment regimens and adherence to national guidelines in Australia: an analysis of dispensing data from the Australian pharmaceutical benefits scheme |
title_fullStr | HIV treatment regimens and adherence to national guidelines in Australia: an analysis of dispensing data from the Australian pharmaceutical benefits scheme |
title_full_unstemmed | HIV treatment regimens and adherence to national guidelines in Australia: an analysis of dispensing data from the Australian pharmaceutical benefits scheme |
title_short | HIV treatment regimens and adherence to national guidelines in Australia: an analysis of dispensing data from the Australian pharmaceutical benefits scheme |
title_sort | hiv treatment regimens and adherence to national guidelines in australia: an analysis of dispensing data from the australian pharmaceutical benefits scheme |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6318998/ https://www.ncbi.nlm.nih.gov/pubmed/30606134 http://dx.doi.org/10.1186/s12889-018-6325-5 |
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