Patient Preference and Adherence (Oct 2022)
“We are Getting Those Old People Things.” Polypharmacy Management and Medication Adherence Among Adult HIV Patients with Multiple Comorbidities: A Qualitative Study
Abstract
Kristin G Bevilacqua,1 Charell Brinkley,2 Joseph McGowan,2 Frances Wallach,2 Rebecca M Schwartz3,4 1Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA; 2Department of Medicine, Division of Infectious Disease, Northwell Health, Manhasset, NY, USA; 3Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Department of Occupational Medicine, Epidemiology and Prevention, Great Neck, NY, USA; 4Institute of Health System Science, Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY, USACorrespondence: Kristin G Bevilacqua, Johns Hopkins University Bloomberg School of Public Health, Department of Population, Family and Reproductive Health, 615 N Wolfe St, Baltimore, MD, 21205, USA, Email [email protected]: Improvements in treatment have led to a growing population of older adults living with HIV. As this population ages, polypharmacy, or the use of more than five medications, may become more common among people living with HIV (PLWH).Methods: Two qualitative focus groups (N=7, N=8) were conducted among a sample of patients who participated in a larger study regarding differential medication adherence. Open-ended questions and probes focused on barriers and facilitators to multiple medication management as well as differential adherence.Results: Overall, patients were able to manage their polypharmacy. Social support facilitated adherence while long-term antiretroviral (ARV) use, medication-specific requirements and emotional fatigue were barriers to management. A small number of participants reported differential adherence that prioritized non-HIV medications over ARVs due to more immediate effects of non-adherence.Discussion: Findings suggest that PLWH have learned to manage their polypharmacy, but still face significant challenges adhering to multiple medications in the long-term. Future research may focus on the emotional toll of long-term ARV use and how patients’ own management strategies may be leveraged to promote adherence.Keywords: HIV/AIDS, polypharmacy, medication management, medication adherence
