Drug-Related Problems (DRPs) in the Use of Antiretroviral Drugs (ARV/ART): A Scoping Review
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Alfa Frista Arta, Beta Herilla Sekti, Moh. Firmansah (2026). Drug-Related Problems (DRPs) in the Use of Antiretroviral Drugs (ARV/ART): A Scoping Review. Journal of Pharmaceutical and Sciences, JPS Volume 9 Nomor 4 (2026). https://doi.org/10.36490/journal-jps.com.v9i4.1737
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Abstract
Background: Antiretroviral therapy (ART) has transformed HIV infection into a manageable chronic disease. However, lifelong ART use and rising comorbidity burdens are associated with various drug-related problems (DRPs) that can lead to virological failure, drug resistance, hospitalization, and increased healthcare costs. Objective: This scoping review aimed to identify and map the types, prevalence, and risk factors of DRPs associated with antiretroviral drug use based on literature published between January 1, 2015, and May 29, 2026, reflecting the modern integrase inhibitor and dual-therapy era. Methods: We conducted a scoping review using the Population, Concept, and Context (PCC) framework. We searched PubMed, Scopus, and the Cochrane Library for articles published from January 1, 2015, to May 29, 2026 (final search on May 29, 2026). Two reviewers independently selected studies and charted data using Mendeley in accordance with the PRISMA-ScR guideline, and appraised primary observational studies using the Newcastle-Ottawa Scale (NOS). Results: Of the 3,298 articles initially identified, 18 articles met the inclusion criteria, encompassing 12,981 participants across 11 primary observational studies and >60,900 cumulative participants synthesized across 7 review and meta-analysis articles. The main DRPs identified included drug-drug interactions (DDIs), adverse drug reactions (ADRs), polypharmacy, medication non-adherence, medication errors, and inappropriate regimens. The prevalence of DDIs ranged from 7.0% for contraindicated interactions to 65.5% for interactions across all severity levels (with 47.5% to 77.0% of identified clinically significant interactions being potentially clinically relevant). A meta-analysis in Ethiopia reported a pooled prevalence of ART-related ADRs of 36.7%, while polypharmacy was reported in a pooled global prevalence of 33.0% among people living with HIV. Conclusion: DRPs associated with ART use are multidimensional and driven by regimen-, patient-, and health system-related factors. Integrating clinical pharmacists, routine DDI screening, and regimen simplification are key strategies to optimize ART pharmacotherapy. Future studies are also needed to establish a standardized HIV-specific DRP classification and expand real-world evidence in low- and middle-income countries, including Indonesia.
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