Multidisciplinary Care for Older People Living with HIV: Optimizing Medication and Enhancing Quality of Life
Fatma Nisa Balli Turhan, Emre Kara, Zeynep Şahiner, Cafer Balci, Meliha Çağla Sönmezer, Ahmet Çağkan İnkaya, Meltem Gülhan Halil, Serhat Ünal, Kutay DemirkanAbstract
Background
The growing number of older people living with HIV (PLWH) presents challenges in comprehensive care and maintaining health-related quality of life (HRQoL). This study aimed to evaluate the effect of a multidisciplinary intervention focusing on medication optimization and person-centered support on the HRQoL of older PLWH.
Methods
This prospective study included 3 groups: PLWH ≥50 years (older); PLWH <50 years (younger); and HIV-negative individuals ≥50 years. Older PLWH underwent a comprehensive assessment at baseline and approximately six months later, with interventions provided by clinical pharmacists, infectious disease specialists, and geriatricians. Medication Regimen Complexity Index (MRCI), STOPP/START and TIME criteria, and 36-Item Short Form Health Survey (SF-36) were used.
Results
A total of 285 participants were included in this study (50% older PLWH, 25% younger PLWH, and 25% HIV-negative individuals). The mental component summary score of SF-36 was significantly higher in older PLWH compared to younger PLWH at baseline (p=0.001). Antiretroviral therapy regimens were simplified in 24.1%, and at least one medication was deprescribed in 48.9% of older PLWH. Older PLWH demonstrated significant reductions in potentially inappropriate prescribing with STOPP/START and TIME criteria (p<0.001) at the second interview, but no significant changes were observed in MRCI scores (p>0.05). Additionally, physical and mental component summary scores of SF-36 increased significantly (p=0.012 and p<0.001, respectively) after intervention.
Conclusion
Multidisciplinary care was associated over time with reductions in inappropriate prescribing and improvements in HRQoL among older PLWH. These findings underscore the need for integrated, person-centered, age-tailored HIV care models to support healthy ageing.