Evidence map›Paper›PMID 39315489›Full record

Observational studyHIV medicine2024

Cardiovascular medication adherence testing in patients living with HIV: A single-centre observational study.

Joshua Nazareth, Ayobami Adebayo, Muhammad Fahad, Hanfa Karim, Daniel Pan, Shirley Sze, Christopher A Martin, Jatinder S Minhas, Dennis Bernieh, Hanad Osman and 4 more

Abstract readObservational Study
In one paragraph

Observational study in HIV medicine, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Review
  2. Review
  3. Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

Joshua NazarethDepartment of Infection and HIV Medicine, University Hospitals of Leicester NHS Trust, Leicester, UK.
Ayobami AdebayoDepartment of Infection and HIV Medicine, University Hospitals of Leicester NHS Trust, Leicester, UK.
Muhammad FahadDepartment of Infection and HIV Medicine, University Hospitals of Leicester NHS Trust, Leicester, UK.
Hanfa KarimDepartment of Infection and HIV Medicine, University Hospitals of Leicester NHS Trust, Leicester, UK.
Daniel PanDepartment of Infection and HIV Medicine, University Hospitals of Leicester NHS Trust, Leicester, UK.
Shirley SzeLeicester NIHR Biomedical Research Centre, Leicester, UK.
Christopher A MartinDepartment of Infection and HIV Medicine, University Hospitals of Leicester NHS Trust, Leicester, UK.
Jatinder S MinhasLeicester NIHR Biomedical Research Centre, Leicester, UK.
Dennis BerniehDepartment of Cardiovascular Sciences, University of Leicester, Leicester, UK.
Hanad OsmanDepartment of Cardiovascular Sciences, University of Leicester, Leicester, UK.
Phayre ElverstoneDepartment of Infection and HIV Medicine, University Hospitals of Leicester NHS Trust, Leicester, UK.
Iain StephensonDepartment of Infection and HIV Medicine, University Hospitals of Leicester NHS Trust, Leicester, UK.
Pankaj GuptaLeicester NIHR Biomedical Research Centre, Leicester, UK.
Manish PareekDepartment of Infection and HIV Medicine, University Hospitals of Leicester NHS Trust, Leicester, UK.

Funding

Applied Research Collaboration East MidlandsNational Institute for Health and Care ResearchNIHR Doctoral Research Fellowship NIHR302338NIHR Leicester Biomedical Research Centre
6 · The paper itself

Abstract

introductionPeople with HIV (PWH) are at an increased risk of developing cardiovascular disease (CVD) compared to HIV-negative individuals. We sought to evaluate the adherence to medications for CVD in PWH and identify factors associated with non-adherence to these medications.

methodsWe conducted a cross-sectional study at the University Hospitals of Leicester NHS Trust between 16 April 2019 and 8 November 2022. We recruited consecutive PWH, who were attending a routine follow-up outpatient appointment and were prescribed at least one medication for CVD. In addition, we included urinary adherence results of patients with samples collected as part of routine clinical care. We used liquid chromatography-tandem mass spectrometry (LC-MS/MS) to assess if their prescribed medications (antihypertensives, diuretics, beta-blockers, lipid-lowering agents, antiplatelets, anticoagulants, antidiabetic medications) were present in the participant's urine sample. Multivariable models were used to identify demographic or clinical features that were associated with non-adherence.

resultsA total of 162 PWH were included in the analysis. Median age was 55 [interquartile range (IQR): 50-61] years, 63% were male, average time living with HIV was 15 years (IQR: 11-19) and the majority (98%) had an undetectable HIV viral load. In approximately one-third of patients (59/162), at least one prescribed medication of interest was not detected in urine. Non-adherence to lipid-lowering agents was common (35/88, 40%). On multivariable logistic regression, the number of prescribed cardiovascular medications, was associated with medication non-adherence [medication non-adherence, per one medication increase: adjusted odds ratio (95% confidence interval) = 1.78 (1.34-2.36); p < 0.001].

conclusionWe found sub-optimal adherence to medications for CVD in PWH. In order to maximize the clinical benefit of statin therapy in PWH, factors requiring consideration include: improved medication adherence, awareness of polypharmacy, educational interventions and quantitative assessment of sub-optimal adherence through chemical adherence testing.

Indexed as

Cardiovascular DiseasesDrug MonitoringHIV InfectionsAntihypertensive AgentsCardiovascular AgentsChromatography, LiquidCross-Sectional StudiesFemaleHumansMaleMiddle AgedTandem Mass SpectrometryAntihypertensive AgentsCardiovascular Agentsadherencecardiovascular diseasecomorbidityHIVstatins

Identifiers

PMID39315489
PMCPMC11608581

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.