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Tenofovir substitution in Namibia based on an analysis of the antiretroviral dispensing database

Overview of attention for article published in Journal of Pharmaceutical Policy and Practice, April 2015
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Title
Tenofovir substitution in Namibia based on an analysis of the antiretroviral dispensing database
Published in
Journal of Pharmaceutical Policy and Practice, April 2015
DOI 10.1186/s40545-015-0034-6
Pubmed ID
Authors

Francis Kalemeera, Assegid T Mengistu, Johannes Gaeseb

Abstract

In the management of HIV infection, tenofovir is preferred to its predecessors - zidovudine and stavudine - in the antiretroviral therapy (ART) nucleoside backbone. Tenofovir's (TDF) preference is based on its safety profile. Nevertheless, TDF causes adverse reactions, some of which warrant its substitution for patients. The rate of TDF-substitution is suggestive of the rate of occurrence of TDF-related adverse reactions. However, the rate of substitution of TDF with another nucleoside reverse transcriptase inhibitor (NRTI) in Namibia was unknown. The objective of this review was to measure the rate of TDF's substitution for the period of January 1, 2008 to November 30, 2011, and to compare the gender difference in the rates of TDF's substitution. We accessed antiretroviral medicine dispensing records from the national antiretroviral dispensing database (NDB). We selected patients who were started on a TDF-containing conventional ART regimen - 2NRTI+1NNRT. We used the initial and current ART regimens to identify records of TDF's substitution with another NRTI. A total of 84,741 patients were initiated on ART (Jan-1-2008 to Nov-30-2011). A total of 52,612 patient-records were excluded from the analysis because they did not meet the criteria for inclusion. Of the 32,129 included records, 59.4% (n=19 096) and 40.6% (n=13 033) were for female and male patients, respectively. Of these, 1.2% (n=380) of the patients had their TDF substituted with another NRTI. Of the females and males, respectively, 1.1% (95% CI: 0.9-1.3; n=210) and 1.3% (95% CI: 1.1-1.5; n=170) had TDF substituted with another NRTI. No gender difference was observed (p-value = 0.11). The percentage of patients for whom TDF was substituted with another NRTI, possibly due to TDF-related adverse reactions, was within the current published limits. However, 1.2% is likely not a true representation of the percentage of patients who experience adverse events because some patients could have been maintained on TDF even in the presence of adverse events. Further investigation is required to determine the clinical reasons for TDF's withdrawal.

Twitter Demographics

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Mendeley readers

The data shown below were compiled from readership statistics for 7 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 7 100%

Demographic breakdown

Readers by professional status Count As %
Researcher 3 43%
Lecturer > Senior Lecturer 1 14%
Student > Ph. D. Student 1 14%
Student > Doctoral Student 1 14%
Unspecified 1 14%
Other 0 0%
Readers by discipline Count As %
Unspecified 2 29%
Nursing and Health Professions 1 14%
Pharmacology, Toxicology and Pharmaceutical Science 1 14%
Psychology 1 14%
Social Sciences 1 14%
Other 1 14%

Attention Score in Context

This research output has an Altmetric Attention Score of 2. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 15 May 2015.
All research outputs
#2,517,260
of 5,099,351 outputs
Outputs from Journal of Pharmaceutical Policy and Practice
#53
of 79 outputs
Outputs of similar age
#82,785
of 156,484 outputs
Outputs of similar age from Journal of Pharmaceutical Policy and Practice
#7
of 9 outputs
Altmetric has tracked 5,099,351 research outputs across all sources so far. This one is in the 47th percentile – i.e., 47% of other outputs scored the same or lower than it.
So far Altmetric has tracked 79 research outputs from this source. They receive a mean Attention Score of 4.5. This one is in the 26th percentile – i.e., 26% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 156,484 tracked outputs that were published within six weeks on either side of this one in any source. This one is in the 42nd percentile – i.e., 42% of its contemporaries scored the same or lower than it.
We're also able to compare this research output to 9 others from the same source and published within six weeks on either side of this one. This one has scored higher than 2 of them.