Antiretroviral and Medication Errors in Hospitalized HIV-Positive Patients

Abstract

Although studies varied greatly in methodology, overall, a large number of medication errors occurred in this patient population. This underscores the important role the pharmacist has in optimizing care to hospitalized HIV-positive patients and provides further insights into the types of medication errors that occur and proposed solutions to reduce these errors. Because medication errors are multifactorial, ongoing initiatives to improve the quality of medication reconciliation processes, educate the health care team on antiretroviral medications, and improve the drug distribution system are required.

Acute Care Management of the HIV‐Infected Patient: A Report from the HIV Practice and Research Network of the American College of Clinical Pharmacy

“…Medication error rates are magnified in HIV‐infected patients as a consequence of complex regimens and lack of provider experience with ART prescribing . Antiretroviral medication error rates vary widely in hospitalized patients with HIV infection, with reports in the literature ranging from 5–86% . Errors most commonly occur at hospital admission (72% of total errors), with 52% attributed to incorrect ART prescribing .…”

ASHP Guidelines on Pharmacist Involvement in HIV Care

“…200 Pharmacists should assist other healthcare providers in providing seamless care transitions (from outpatient care to institutional care, during hospitalization, and at the time of discharge) to prevent medication errors. 201 Pill burden, adverse effects, and demands on time and attention pose considerable obstacles to adherence; helping patients obtain their medications in a timely manner removes one major obstacle.…”

Antiretroviral Stewardship in a Pediatric HIV Clinic

“…Medication errors such as drug omissions, dosing errors, and major drug-drug interactions, occur in up to 86% of HIV-infected inpatients 5,6,7 . Antimicrobial stewardship programs (ASPs) have been advocated to optimize antimicrobial selection, dosing, route, and duration of therapy to maximize clinical cure while limiting unintended consequences, such as emergence of resistance, adverse drug events, and cost 8 .…”

“…The same core strategies recommended for ASPs could be applied to optimize therapy in HIV-infected individuals. Several studies have investigated the role of various interventions on reducing medication errors in hospitalized HIV-infected patients 7,9-18 , as well as in the outpatient HIV clinic setting 19-25 . However, few studies assessed the appropriateness of ARV regimens based on resistance testing 21,24 , and few evaluated clinical outcomes such as CD4 gains and VL suppression 21,22,24 .…”