NYMC Faculty Publications

Polypharmacy Is Associated With Falls in Women With and Without HIV

Christina K. Psomas, Department of Infectious Diseases and Internal Medicine, European Hospital Marseille, Marseille, France.
Donald R. Hoover, Department of Statistics and Biostatistics and Institute for Health, Health Care Policy and Aging Research, Rutgers University, Piscataway, NJ.
Qiuhu Shi, Department of Epidemiology and Community Health, New York Medical College, Valhalla, NY.
Todd T. Brown, Division of Endocrinology, Diabetes and Metabolism, Johns Hopkins University, School of Medicine, Baltimore, MD.
David E. Vance, School of Nursing, The University of Alabama at Birmingham, Birmingham, AL.
Susan Holman, Department of Medicine/STAR Program, State University of New York Downstate Health Sciences University, Brooklyn, NY.
Michael W. Plankey, Department of Medicine, Georgetown University Medical Center, Washington, DC.
Phyllis C. Tien, Department of VA Medical Center, San Fransisco, CA.
Kathleen M. Weber, Department of Medicine, Cook County Health/CORE Center and Hektoen Institute of Medicine, Chicago, IL.
Michelle Floris-Moore, University of North Carolina School of Medicine, Chapel Hill, NC.
Hector H. Bolivar, Department of Medicine, University of Miami Health System, Miami, FL.
Elizabeth T. Golub, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.
Marcia McDonnell Holstad, Emory School of Nursing, Atlanta, GA.
Kendra K. Radtke, Department of Bioengineering and Therapeutic Sciences, University of California San Francisco School of Pharmacy, San Francisco, CA.
Bani Tamraz, University of California, San Francisco, School of Pharmacy, San Francisco, CA.
Kristine M. Erlandson, Department of Medicine, University of Colorado Denver, Anschutz Medical Campus, Aurora, CO.
Leah H. Rubin, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.
Anjali Sharma, Department of Medicine, Albert Einstein College of Medicine, Bronx, NY.

Author Type(s)

Faculty

DOI

10.1097/QAI.0000000000002955

Journal Title

Journal of Acquired Immune Deficiency Syndromes

First Page

351

Last Page

359

Document Type

Article

Publication Date

7-1-2022

Department

Public Health

Abstract

BACKGROUND: Aging in people with HIV is associated with increased risk of developing synergistic conditions such as neurocognitive impairment, polypharmacy, and falls. We assessed associations between polypharmacy (use of 5 or more non-ART medications), use of neurocognitive adverse effects (NCAE) medications, and odds of falls in women with HIV (WWH) and without HIV (HIV-). METHODS: Self-reported falls and medication use data were contributed semiannually by 1872 (1315 WWH and 557 HIV-) Women's Interagency HIV Study participants between 2014 and 2016. Polypharmacy and NCAE medication use were evaluated separately and jointly in multivariable models to assess their independent contributions to single and multiple falls risk. RESULTS: The proportion of women who reported any fall was similar by HIV status (19%). WWH reported both greater polypharmacy (51% vs. 41%; P < 0.001) and NCAE medication use (44% vs. 37%; P = 0.01) than HIV- women. Polypharmacy conferred elevated odds of single fall [adjusted odds ratio (aOR) 1.67, 95% CI: 1.36 to 2.06; P < 0.001] and multiple falls (aOR 2.31, 95% CI: 1.83 to 2.93; P < 0.001); the results for NCAE medications and falls were similar. Both polypharmacy and number of NCAE medications remained strongly and independently associated with falls in multivariable models adjusted for HIV serostatus, study site, sociodemographics, clinical characteristics, and substance use. CONCLUSIONS: Polypharmacy and NCAE medication use were greater among WWH compared with HIV-, and both were independently and incrementally related to falls. Deprescribing and avoidance of medications with NCAEs may be an important consideration for reducing fall risk among WWH and sociodemographically similar women without HIV.

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