HIV treatment regimens and adherence to national guidelines in Australia: an analysis of dispensing data from the Australian pharmaceutical benefits scheme
Abstract 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 comorbidi...
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| Format: | Article |
| Language: | English |
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BMC
2019-01-01
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| Series: | BMC Public Health |
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| Online Access: | http://link.springer.com/article/10.1186/s12889-018-6325-5 |
| _version_ | 1819128178833096704 |
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| author | Nila J. Dharan Tomas Radovich Samuel Che Kathy Petoumenos Prabhjot Juneja Matthew Law Robin Huang Hamish McManus Mark N. Polizzotto Rebecca Guy Peter Cronin David A. Cooper Richard T. Gray |
| author_facet | Nila J. Dharan Tomas Radovich Samuel Che Kathy Petoumenos Prabhjot Juneja Matthew Law Robin Huang Hamish McManus Mark N. Polizzotto Rebecca Guy Peter Cronin David A. Cooper Richard T. Gray |
| author_sort | Nila J. Dharan |
| collection | DOAJ |
| description | Abstract 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. |
| first_indexed | 2024-12-22T08:23:42Z |
| format | Article |
| id | doaj.art-150ae34de6fd414cbc84d7b2f9e4bb8f |
| institution | Directory Open Access Journal |
| issn | 1471-2458 |
| language | English |
| last_indexed | 2024-12-22T08:23:42Z |
| publishDate | 2019-01-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Public Health |
| spelling | doaj.art-150ae34de6fd414cbc84d7b2f9e4bb8f2022-12-21T18:32:40ZengBMCBMC Public Health1471-24582019-01-0119111110.1186/s12889-018-6325-5HIV treatment regimens and adherence to national guidelines in Australia: an analysis of dispensing data from the Australian pharmaceutical benefits schemeNila J. Dharan0Tomas Radovich1Samuel Che2Kathy Petoumenos3Prabhjot Juneja4Matthew Law5Robin Huang6Hamish McManus7Mark N. Polizzotto8Rebecca Guy9Peter Cronin10David A. Cooper11Richard T. Gray12Kirby Institute, UNSW SydneyProspection Pty LtdProspection Pty LtdKirby Institute, UNSW SydneyProspection Pty LtdKirby Institute, UNSW SydneyKirby Institute, UNSW SydneyKirby Institute, UNSW SydneyKirby Institute, UNSW SydneyKirby Institute, UNSW SydneyProspection Pty LtdKirby Institute, UNSW SydneyKirby Institute, UNSW SydneyAbstract 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.http://link.springer.com/article/10.1186/s12889-018-6325-5HIVART guidelinesDrug-drug interactionsPharmaceutical benefits schemeComorbidities |
| spellingShingle | Nila J. Dharan Tomas Radovich Samuel Che Kathy Petoumenos Prabhjot Juneja Matthew Law Robin Huang Hamish McManus Mark N. Polizzotto Rebecca Guy Peter Cronin David A. Cooper Richard T. Gray HIV treatment regimens and adherence to national guidelines in Australia: an analysis of dispensing data from the Australian pharmaceutical benefits scheme BMC Public Health HIV ART guidelines Drug-drug interactions Pharmaceutical benefits scheme Comorbidities |
| 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 | HIV ART guidelines Drug-drug interactions Pharmaceutical benefits scheme Comorbidities |
| url | http://link.springer.com/article/10.1186/s12889-018-6325-5 |
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