Assuntos
Infecções por HIV/tratamento farmacológico , Hepatite B/tratamento farmacológico , Hepatite C/tratamento farmacológico , Transtornos Mentais/induzido quimicamente , Doenças do Sistema Nervoso/induzido quimicamente , Oligopeptídeos/efeitos adversos , Sulfonamidas/efeitos adversos , Antivirais/administração & dosagem , Antivirais/efeitos adversos , Bosentana , Interações Medicamentosas , Infecções por HIV/complicações , Hepatite B/complicações , Hepatite C/complicações , Humanos , Masculino , Pessoa de Meia-Idade , Oligopeptídeos/administração & dosagem , Sulfonamidas/administração & dosagemRESUMO
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.
Assuntos
Carbamatos/uso terapêutico , Infecções por HIV/tratamento farmacológico , Inibidores da Protease de HIV/uso terapêutico , HIV-1/genética , Sulfonamidas/uso terapêutico , Contagem de Linfócito CD4 , Darunavir , Farmacorresistência Viral/genética , Quimioterapia Combinada , Furanos , Infecções por HIV/genética , Infecções por HIV/virologia , Humanos , Inibidores da Transcriptase Reversa/uso terapêutico , Fatores de Risco , Ritonavir/uso terapêutico , Falha de Tratamento , Carga ViralRESUMO
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.