Journal Article

Polypharmacy In Adults with HIV and Substance Dependence Leads to Falls and Fractures

Utilizing an electronic medical record review in 250 adults (median age of 50 years) with HIV infection, substance dependence, or ever injection drug use, various categories of medication intake were determined. These categories included: overall systemically active; overall active but excluding antiretroviral (ARV); sedating, non-opioid sedating including gabapentin, trazodone, other anti-depressive medications; and opioids. The outcomes were self reported and included falls or accidents requiring medical attention and any fractures in the previous year. For each medication used the odds of falls increased significantly. This was particularly true for non-opioid sedating drugs. Specifically, 8 or more overall non-ARV medications or 2 or more sedating medications were the most predictive. There was a similar relationship for fractures, although this analysis was non-significant. The relationships between medications and falls/fractures were driven mainly by the sedating medications. The results suggest care in prescribing unnecessary medications and caution in using sedating medications in a vulnerable population because of the higher risk of falls and fractures.

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