Impact of Over-the-Counter Medication Misuse and Adverse Drug Events on HIV Patients' Health-Related Quality of Life

Background: Over-the-counter (OTC) medication use has increased among HIV-infected patients. Inappropriate use of OTC drugs may increase the risk of potential adverse drug events (ADEs), thus decreasing health-related quality of life (HRQL). Objective: To examine the effect of OTC medication misuse and associated ADEs on HRQL of HIV-infected patients. Methods: A cross-sectional field study with HIV-infected patients from an HIV clinic in Houston, Texas, was conducted from April 1, 2005, to June 30, 2005. A validated questionnaire (including questions on OTC medications used; ADEs experienced; and HRQL, Short Form-12, version 2 scale) was administered using self-administered and personal interview techniques. Cronbach's α was estimated to evaluate internal consistency for HRQL scores and χ2 and t-test analyses were performed to evaluate the effect of OTC misuse on ADEs and on HRQL. Results: Of the 215 respondents, 80 (37.2%) misused OTC medications. Thirty-six participants (16.7%) experienced ADEs due to OTC use or misuse. ADE incidence was significantly higher in patients misusing OTCs. Significantly lower HRQL scores for the physical component summary score domains were observed in patients reporting ADEs versus those who did not. Conclusions: HIV-infected patients had lower HRQL scores when they experienced an OTC-associated ADE. Patients misusing OTC medications had a higher incidence of associated ADEs. Interventions by healthcare providers and patients aimed at reducing misuse and ADEs due to OTC medications would improve care and the quality of life for HIV-infected patients.