Prevalence of Potentially Inappropriate Medications in Elderly HIV/AIDS Patients

In a groundbreaking multicenter cross-sectional study published in the *Clinical Interventions in Aging* journal, researchers investigated the prevalence of potentially inappropriate medication (PIM) use among older patients living with HIV/AIDS. The study, which spanned from 2019 to 2023 and included data from 21 hospitals across eight Chinese cities, revealed a concerning PIM prevalence of 23.20% among the cohort of 2,642 patients, primarily aged 65 and older. The research emphasizes the urgent need for enhanced medication oversight in this vulnerable population.

The study's authors, led by Dr. Jia Li from Zhejiang University School of Medicine, utilized the 2023 American Geriatrics Society Beers Criteria to categorize medications deemed inappropriate for older adults. They found that the largest category of PIMs consisted of medications contraindicated in older patients, accounting for 51.87% of cases. Furthermore, the analysis highlighted a significant trend towards polypharmacy, with the adjusted odds ratio for PIM use skyrocketing to 9.05 for patients taking five or more medications.

Aging poses unique challenges for individuals living with HIV, as they often face multiple chronic conditions that complicate medication management. The study found that 46.18% of participants had five or fewer concurrent diagnoses, while 53.82% had more than five, with polypharmacy being identified as a substantial predictor of PIM use. Inpatient treatment settings were also associated with a higher likelihood of PIM prescriptions, reflecting the complexities of managing medications for hospitalized patients.

Despite the alarming prevalence of PIM use, the study observed a statistically significant downward trend in the use of medications requiring cautious use (Type 3 PIMs), suggesting potential improvements in prescribing practices over the study period. However, the overall increase in the use of single PIMs raises concerns about the implications of medication safety for this demographic, particularly during the ongoing COVID-19 pandemic, which may have disrupted regular healthcare services.

The authors stress the importance of targeted interventions aimed at reducing PIM use among older adults living with HIV/AIDS. They advocate for systematic medication reviews and enhanced medication stewardship programs in clinical settings to optimize therapeutic regimens and enhance patient safety. As the elderly population of HIV/AIDS patients continues to grow in China, with a reported prevalence of 1.68% among older adults, the findings of this study underscore the critical need for ongoing research and policy development to improve medication safety for this demographic.

In conclusion, this comprehensive investigation into the patterns of PIM use among older HIV/AIDS patients in China highlights the complex interplay between aging, chronic disease management, and medication safety. The study calls for a concerted effort from healthcare providers to implement strategies that prioritize the health and well-being of this vulnerable population, ensuring that their medication regimens are safe, effective, and appropriate.

**References**: 1. Li J, Hong D, Dong J, Zhao Q, Wang H. Potentially Inappropriate Medication and Associated Factors Among Older Patients with HIV/AIDS: A Multicenter Cross-Sectional Study. *Clinical Interventions in Aging*. 2025;20:1155-1164. 2. American Geriatrics Society. Beers Criteria for Potentially Inappropriate Medication Use in Older Adults. 2023. 3. Chinese Center for Disease Control and Prevention. HIV/AIDS Statistics in China. 2023. 4. Morley KI, Ferris JA, Winstock AR, Lynskey MT. Polypharmacy and risk of falls and fractures for patients with HIV infection. *AIDS Care*. 2018;30(2):150-159. 5. Greene M, Steinman MA, McNicholl IR, Valcour V. Polypharmacy, drug-drug interactions, and potentially inappropriate medications in older adults with human immunodeficiency virus infection. *J Am Geriatr Soc*. 2014;62(3):447-453.