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South African healthcare workers' knowledge of dolutegravir's drug-drug interactions in the first year of its rollout: a cross-sectional online survey.
Chisholm, Briony S; Swart, Annoesjka M; Blockman, Marc.
  • Chisholm BS; Division of Clinical Pharmacology, National HIV and TB Healthcare Worker Hotline, Medicines Information Centre, University of Cape Town, Cape Town, South Africa.
  • Swart AM; Division of Clinical Pharmacology, National HIV and TB Healthcare Worker Hotline, Medicines Information Centre, University of Cape Town, Cape Town, South Africa.
  • Blockman M; Division of Clinical Pharmacology, University of Cape Town, Cape Town, South Africa.
J Int AIDS Soc ; 25(3): e25885, 2022 03.
Article in English | MEDLINE | ID: covidwho-1729149
ABSTRACT

INTRODUCTION:

In December 2019, dolutegravir-based treatment was recommended as first-line antiretroviral therapy (ART) in South Africa. Dolutegravir has clinically significant interactions with several commonly used drugs, such as rifampicin, metformin and cation-containing medicines. National guidelines detail these interactions and how to manage them. While previous international studies have shown low healthcare worker knowledge of drug-drug interactions, there is a paucity of information on antiretroviral interaction knowledge in the South African setting, where much ART is nurse-led. The study aimed to determine this knowledge and to describe which variables were associated with gaps in knowledge.

METHODS:

An anonymous online survey of healthcare workers in the field of HIV was conducted in August/September 2020. The survey was designed, tested and piloted, and included sections on demographics, guideline access and training, interaction knowledge, counselling and the effect of COVID-19. Dissemination was via e-mail and social media (convenience sampling). Descriptive and inferential analysis was done using proportions and the 95% confidence interval to determine relationships between independent and dependent variables. Research ethics approval was obtained from the University of Cape Town's Human Research Ethics Committee (HREC Ref 357/2020). RESULTS AND

DISCUSSION:

In total, 1950 survey responses were included in the analysis - 47.1% nurses, 35.8% doctors and 8.9% pharmacists. When asked whether they were aware that dolutegravir has interactions, 70% said yes, 13.9% said no and 16.1% did not answer. Knowledge of specific interactions and the dosing changes needed was low with a wide range between different drugs 79.7% knew to double the dolutegravir dose with rifampicin, but with calcium, 5.1% picked both correct dosing options and 33.7% picked one of the two correct options. Access to guidelines and training were positively associated with drug interaction knowledge.

CONCLUSIONS:

There are gaps in the awareness and knowledge of dolutegravir interactions and how to adjust dosing among South African healthcare workers.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: HIV Infections / COVID-19 Type of study: Observational study / Prognostic study / Randomized controlled trials Limits: Humans Country/Region as subject: Africa Language: English Journal: J Int AIDS Soc Journal subject: SINDROME DA IMUNODEFICIENCIA ADQUIRIDA (AIDS) Year: 2022 Document Type: Article Affiliation country: Jia2.25885

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Full text: Available Collection: International databases Database: MEDLINE Main subject: HIV Infections / COVID-19 Type of study: Observational study / Prognostic study / Randomized controlled trials Limits: Humans Country/Region as subject: Africa Language: English Journal: J Int AIDS Soc Journal subject: SINDROME DA IMUNODEFICIENCIA ADQUIRIDA (AIDS) Year: 2022 Document Type: Article Affiliation country: Jia2.25885