Managing Complexities

In Managing Complexities, Dr. Naomi Sutton is joined by Dr. Lauren Walker to discuss a topic that is becoming more pertinent as people living with HIV live longer: multiple co-morbidities in an aging cohort. The goal has shifted from keeping people living with HIV alive to improving their quality of life as they age. Lauren walks listeners through the relationship between HIV and co-morbidities, the cumulative burden of small harms and the impact of polypharmacy on quality of life. Lauren and Naomi discuss where the responsibility of de-prescribing lies, and when clinicians should undertake medicines optimisation; as well as working towards a more ideal approach to managing co-morbidities in the presence of HIV. " The important point for GPs that are listening is around challenging diagnoses and making sure that actually, that diagnosis is still present, that the person is still dizzy or itchy, so therefore they still need it – because they may not. " " Decisions about medicine shouldn't only be made by the clinician in front of you. It should be a shared decision where we talk about risk and we talk about benefit and the potential harms of medicines and we decide together what's your priority and what do you want to do. " " And that's really important then that if there is medicine that you feel that this patient needs to manage their multiple long-term conditions, then by all means speak to the HIV team to say, is this safe?"

Resources: Liverpool Combined Comorbidities Calculator, University of Liverpool

Dr. Lauren Walker is Senior Clinical Lecturer in Clinical Pharmacology & Therapeutics and an Honorary Consultant in General Internal Medicine at the University of Liverpool. She is the Academic Director of the university’s NIHR Clinical Research Facility, and a co-Director of the Liverpool Early Phase Hub. Lauren’s research and clinical interests include improving the safe and effective real-world use of medicines in adults with complex multimorbidity & polypharmacy. Lauren also co-chairs a National Polypharmacy Services Consortium (PPSC).

UK-UNB-5076

Jan 2024

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