Dr. Alice Tseng
Dr. Alice Tseng, HIV Pharmacotherapy Specialist in the HIV clinic at TG, shows the mobile app which alerts healthcare professionals to harmful drug interactions for patients who have HIV or hepatitis C and other illnesses. It is designed for both iPhone/ iPad and Android devices, and no password is required. (Photo: UHN)

A one-of-a-kind free mobile app, which instantly alerts healthcare professionals to harmful drug interactions for patients who have HIV or hepatitis C and other illnesses, has been co-developed by a pharmacist in the HIV Clinic at Toronto General Hospital (TG).

A team of computer programmers, a software designer, and pharmacists designed an intuitive, multi-platform search engine to access the most up-to-date scientific information on drug interactions, with a colour-coded alert by severity of the drug interaction, and suggestions for safer treatment alternatives.

The application, called the HIV/HCV Drug Therapy Guide, includes more than 50 HIV and hepatitis C drugs, with 500 other commonly prescribed drugs, involving more than 15,000 drug combinations. It is designed for both iPhone/iPad and Android devices, and no password is required.

According to the Centers for Disease Control and Prevention, about 25 per cent of people with HIV in the U.S. also have hepatitis C. Healthcare providers prescribe HIV and hepatitis C medicines carefully to avoid drug interactions and follow patients for any side effects.

Alice Tseng, HIV Pharmacotherapy Specialist in the HIV clinic at TG and member of the team involved in the app design, says the app has been widely used, with more than 1,000 unique visitors in one month from North America, Australia, Spain, France and Germany. These visitors searched more than 2,157 drug interactions.

"People love it," she says, adding there are only a few similar apps in the world, but none with data for both HIV and hepatitis C.

"The app is updated regularly as new data emerge, including new investigational and recently approved drugs."

This is one of the many ways the HIV clinic is contributing to patient safety and making this information available worldwide at the touch of anyone's fingertips, adds Milijana Buzanin, Nurse Manager of the HIV clinic at TG.

"It has made a huge difference to specialists and general practitioners who care for patients requiring complex medications."

Tseng points out that patients with the HIV virus today can expect to live decades longer than those who were diagnosed over 20 years ago. Developments in antiretroviral therapy – drugs that slow down the HIV infection and introduced in the 1990s – have boosted survival rates. Patients can now expect to have close to normal life expectancy, she says.

As HIV drugs have become more effective and people are living longer, they are now experiencing other illness related to aging, such as diabetes, high cholesterol and high blood pressure, says Tseng.

"In the early part of this epidemic, we worried about HIV and related infections," she says, "But the challenge has shifted to ensuring that HIV medications do not interact with other more commonly used drugs."

She points to a 2013 study of HIV patients at TG which showed those who were 50 years and older were on nine medications as compared to seven medications taken by younger patients.

Consequently, the older patients were more likely to have one potentially serious drug interaction that could lead to serious side effects or affect how well the HIV drugs are working.

Other studies have shown that about 70 per cent of patients with HIV and hepatitis C had drug interactions, and about 60 per cent required modification of their treatment.

Other members of the development team include the following pharmacists: Michelle Foisy, Northern Alberta Health Services; and Pierre Giguere, The Ottawa Hospital.

The app is available for free download on Google Play and iTunes.

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