Sedative Co-Medication Patterns Across Frailty States in People with HIV: A Network-Based Study

Sedative Co-Medication Patterns Across Frailty States in People with HIV: A Network-Based Study | Authorea try { document.documentElement.classList.add('js'); } catch (e) { } var _gaq = _gaq || []; _gaq.push(['_setAccount', 'G-8VDV14Y67G']); _gaq.push(['_trackPageview']); (function() { var ga = document.createElement('script'); ga.type = 'text/javascript'; ga.async = true; ga.src = ('https:' == document.location.protocol ? 'https://ssl' : 'http://www') + '.google-analytics.com/ga.js'; var s = document.getElementsByTagName('script')[0]; s.parentNode.insertBefore(ga, s); })(); Skip to main content Preprints Collections Wiley Open Research IET Open Research Ecological Society of Japan All Collections About About Authorea FAQs Contact Us Quick Search anywhere Search for preprint articles, keywords, etc. Search Search ADVANCED SEARCH SCROLL This is a preprint and has not been peer reviewed. Data may be preliminary. 11 March 2025 V1 Latest version Share on Sedative Co-Medication Patterns Across Frailty States in People with HIV: A Network-Based Study Authors : HENRY MICHAEL 0000-0002-1944-0650 [email protected] , Marie-Josee Brouillette , Robin Tamblyn , Lesley Fellows , and Nancy Mayo Authors Info & Affiliations https://doi.org/10.22541/au.174168213.36209468/v1 Published International Journal of Clinical Pharmacy Version of record Peer review timeline 348 views 155 downloads Contents Abstract Supplementary Material Information & Authors Metrics & Citations View Options References Figures Tables Media Share Abstract Objective To describe sedative co-medication patterns across frailty states (robust, prefrail, frail) in people living with HIV using network-based analysis, aiming to identify key medication interactions and network drivers that can guide safer therapeutic approaches. Methods This cross-sectional study analyzed 321 participants using sedatives from the Positive Brain Health Now Cohort (mean age: 53 years), categorized as robust (30.2%), prefrail (47.0%), or frail (22.7%). Sedative use was classified using the Sedative Load Model, and frailty was assessed with a modified Fried Frailty Phenotype. Co-medication networks were constructed for robust, prefrail, and frail groups, with metrics such as Neighborhood Shift Scores (NESH) and Delta Betweenness used to evaluate network dynamics. Edge-level Observed-to-Expected (O/E) ratios highlighted significant co-prescription patterns and associated drug-drug interactions. Results Frail individuals exhibited the most interconnected network, characterized by higher graph density and average degree compared to robust and prefrail groups. Key ”driver” medications identified were mirtazapine (robust-to-prefrail), gabapentin (robust-to-frail), and pregabalin (prefrail-to-frail). In frail individuals, medication pairs with high O/E ratios (e.g., hydromorphone-clonazepam, O/E: 3.07), posed a potential risk for severe drug interactions requiring therapy modification. Robust individuals displayed fewer and less severe drug interactions, whereas prefrail individuals exhibited an intermediate level of complexity. Conclusion Sedative co-medication patterns vary significantly across frailty states in people with HIV, with frailty amplifying risks of severe drug interactions. Identifying key medications as network drivers provides actionable insights to optimize therapeutic approaches, particularly for depression and neuropathic pain management in prefrail and frail stages. Supplementary Material File (main manuscript.docx) Download 85.12 KB Information & Authors Information Version history V1 Version 1 11 March 2025 Peer review timeline Published International Journal of Clinical Pharmacy Version of Record 15 Jul 2025 Published Copyright This work is licensed under a Non Exclusive No Reuse License. Keywords ageing drug interactions geriatrics hiv/aids infectious diseases pharmacokinetics psychopharmacology sedation Authors Affiliations HENRY MICHAEL 0000-0002-1944-0650 [email protected] McGill University Faculty of Medicine and Health Sciences View all articles by this author Marie-Josee Brouillette McGill University Faculty of Medicine and Health Sciences View all articles by this author Robin Tamblyn McGill University Faculty of Medicine and Health Sciences View all articles by this author Lesley Fellows McGill University Faculty of Medicine and Health Sciences View all articles by this author Nancy Mayo McGill University Faculty of Medicine and Health Sciences View all articles by this author Metrics & Citations Metrics Article Usage 348 views 155 downloads .FvxKWukQNSOunydq8rnd { width: 100px; } Citations Download citation HENRY MICHAEL, Marie-Josee Brouillette, Robin Tamblyn, et al. Sedative Co-Medication Patterns Across Frailty States in People with HIV: A Network-Based Study. Authorea . 11 March 2025. DOI: https://doi.org/10.22541/au.174168213.36209468/v1 If you have the appropriate software installed, you can download article citation data to the citation manager of your choice. Simply select your manager software from the list below and click Download. For more information or tips please see 'Downloading to a citation manager' in the Help menu . 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