Multimorbidity and Polypharmacy in People With HIV vs. the General Population in the Basque Country

A Comparative Study on the Prevalence of Multimorbidity, Polypharmacy and Potentially Inappropriate Prescriptions Among the General Population and People Living With HIV in the Basque Country

People living with HIV now have a life expectancy similar to that of the general population, thanks to major advances in antiretroviral treatment. As they live longer, many of them experience multiple health conditions at the same time and take several medications, often more than people without HIV. In our region, 6,273 people are currently receiving antiretroviral therapy. However, the new care pathway designed for patients with multiple chronic conditions in the Basque Country's public health system does not include people with HIV. At the same time, we lack local data on how common multimorbidity, polypharmacy, and potentially inappropriate prescribing are among this group. These gaps motivated our study. Our goal is to estimate how frequent these issues are among all people with HIV who receive care in the infectious disease departments of the hospitals in Araba, Basurto, Galdakao, Cruces, and Donostia, and to compare them with a similar group of people without HIV. To do this, we designed a cross-sectional study including the 6,273 people with HIV and a control group from the general population, selected to match them by age, sex, and health centre. By analysing data from electronic health records, we aim to determine whether people with HIV have higher rates of multimorbidity, polypharmacy, and inappropriate prescribing than the general population. The findings from both groups will help us update the care pathway and improve coordinated care for HIV-positive patients with multiple health conditions.

Advances in antiretroviral treatment for people living with Human Immunodeficiency Virus (HIV) have brought their life expectancy into line with that of the general population. These individuals now have a higher prevalence of multiple co-morbidities and polypharmacy than the general population.

According to the latest report on the AIDS plan, there are 6,273 patients in our region currently receiving antiretroviral treatment. However, the recent corporate care pathway for people with multiple co-morbidities in the Basque Country's public health system does not include patients with HIV. This fact, together with the lack of data on the prevalence of multiple co-morbidities, polypharmacy and potentially inappropriate prescribing among these individuals in our region, motivated the conduct of this study. Its aim is to estimate this prevalence among all people with HIV receiving care in the infectious diseases departments of the hospitals in Araba, Basurto, Galdakao, Cruces and Donostia, and to compare it with a control group without HIV. To this end, we designed a cross-sectional comparative study involving 6,273 people with HIV and a control group drawn from the general population through stratified sampling according to the distribution by age, sex and health centre of the HIV population. The results, obtained by extracting data from electronic health records, will enable us to confirm whether the HIV-positive population has a higher prevalence of multimorbidity, polypharmacy and inappropriate prescribing than the general population. The results obtained from both populations will provide us with the necessary knowledge to update the corporate care pathway and to plan coordinated care for HIV-positive patients with multimorbidity.

Inclusion Criteria:

• People with HIV aged 18 or over
• Being monitored by the infectious diseases departments of the Araba, Cruces, Basurto and Donostia University Hospitals and the Galdakao-Usansolo Hospital, all part of Osakidetza.

Exclusion Criteria:

- Being under 18 years of age