Asunto(s)
Infecciones por VIH/tratamiento farmacológico , Hepatitis B/tratamiento farmacológico , Hepatitis C/tratamiento farmacológico , Trastornos Mentales/inducido químicamente , Enfermedades del Sistema Nervioso/inducido químicamente , Oligopéptidos/efectos adversos , Sulfonamidas/efectos adversos , Antivirales/administración & dosificación , Antivirales/efectos adversos , Bosentán , Interacciones Farmacológicas , Infecciones por VIH/complicaciones , Hepatitis B/complicaciones , Hepatitis C/complicaciones , Humanos , Masculino , Persona de Mediana Edad , Oligopéptidos/administración & dosificación , Sulfonamidas/administración & dosificaciónRESUMEN
In highly experienced HIV-1-infected patients, a ritonavir-boosted darunavir-containing regimen was associated with dramatic immunological and virological efficacy. Patients harbouring viruses with amprenavir-specific resistance profiles, such as I50V or V32I + I47V, failed on a darunavir/ritonavir-containing regimen. These key amprenavir mutations were also selected at the time of failure, suggesting their impact on darunavir efficacy.
Asunto(s)
Carbamatos/uso terapéutico , Infecciones por VIH/tratamiento farmacológico , Inhibidores de la Proteasa del VIH/uso terapéutico , VIH-1/genética , Sulfonamidas/uso terapéutico , Recuento de Linfocito CD4 , Darunavir , Farmacorresistencia Viral/genética , Quimioterapia Combinada , Furanos , Infecciones por VIH/genética , Infecciones por VIH/virología , Humanos , Inhibidores de la Transcriptasa Inversa/uso terapéutico , Factores de Riesgo , Ritonavir/uso terapéutico , Insuficiencia del Tratamiento , Carga ViralRESUMEN
BACKGROUND: Medication reconciliation is a powerful process to correct medication errors (ME) resulting from miscommunicated information at transitions of care. This study aims to develop and evaluate a scoring method for assessing the severity of potential harm of ME intercepted by medication reconciliation at hospital admission in elderly. METHODS: The development of the scoring method was based on a literature search and the creation of a list of high-risk drugs used in outpatient care. The evaluation of the method was carried out in 7 French hospitals and was based on two criteria: the inter-rater reliability and acceptability. The assessment of the inter-rater reliability was based on intra-class correlation coefficient (ICC) calculations. Each hospital prospectively enrolled the 10 first patients aged 65 or older presenting with at least one ME. Seven blocks of 10 patients were formed. After randomization, each block was rated by practitioners from 3 hospitals. The assessment of the acceptability was based on a satisfaction questionnaire. RESULTS: A clinical algorithm was developed. The inter-rater reliability of the method was validated by the overall agreement of the 7 hospitals ratings. The agreement was at least substantial (ICC>0.60) and in most of cases almost perfect (ICC>0.80). The acceptability of the method was judged as satisfactory. CONCLUSION: This multi-centre project has validated an instrument for assessing the severity of potential harm of ME intercepted by medication reconciliation. This will allow studies to be conducted with large cohorts of patients in order to develop epidemiological databases of ME of potential clinical significance.