Association of medication regimen complexity index with ADRs in HIV/AIDS patients: a retrospective cohort study

HIV/AIDS患者用药方案复杂性指数与不良反应的相关性:一项回顾性队列研究

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Abstract

PURPOSE: To investigate the correlation between the medication regimen complexity index (MRCI) and adverse drug reactions (ADRs) among acquired immunodeficiency syndrome (AIDS) patients in the Chinese population. INTRODUCTION: The complexity of antiretroviral therapy (ART) regimens in individuals living with human immunodeficiency virus (HIV) presents significant challenges to medication management. To date, no studies have investigated the correlation between the MRCI and ADRs. METHODS: This study retrospectively enrolled 1,010 patients. The MRCI was utilized to quantify the complexity of pharmacological treatment regimens. All suspected ADRs were assessed for causality using the World Health Organization-Uppsala Monitoring Centre (WHO-UMC) system. Univariate and multivariate logistic regression analyses were conducted to identify risk factors associated with ADRs and MRCI. RESULTS: Our findings demonstrate that the MRCI significantly increased from 4.09 ± 4.04 pre-admission to 6.09 ± 6.05 at discharge (P < 0.0001). Comorbidities (>6 diseases) (OR: 2.85, P < 0.001), tuberculosis medications (OR: 1.82, P < 0.001), and the number of medications administered during hospitalization (>19 drugs) (OR: 2.02, P < 0.001) were identified as independent factors influencing MRCI levels. The AUC for predicting adverse reactions using MRCI was 0.58 (P = 0.001), with an optimal cutoff value of 20.75. MRCI (>20.75) (OR: 1.42, P = 0.036) emerged as independent risk factors for adverse reactions in HIV/AIDS patients. CONCLUSION: In China, the MRCI of HIV/AIDS patients significantly increased after hospitalization. Further analysis indicates that patients with higher MRCI are more likely to experience ADRs.

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