Pharmacists reduce Rx errors in HIV patients

A pharmacist’s participation on medical teams treating HIV-positive hospital patients reduces medication errors as well as spots and corrects them sooner, according to a report published in the Annals of Pharmacotherapy.

The goal of the report, “Antiretroviral and Medication Errors in Hospitalized HIV-Positive Patients: A Review of the Literature,” was to summarize literature regarding antiretroviral and other medication errors to find solutions.

The report analyzed 25 studies involving medication errors and HIV-positive hospitalized patients. All of the studies were published between 2000 and 2013 and each involved between 26 and 290 patients. The lead authors of the report were Emily H. Li, PharmD student, University of Alberta, Edmonton and Michelle M. Foisy, PharmD, AAHIVP, Royal Alexandra Hospital, Edmonton, Canada.

“Patients with HIV require additional attention when admitted to hospital because their antiretroviral regimens can be complicated and unfamiliar to care providers. Although studies varied greatly in design, duration, and methods, overall they demonstrated high rates of medication errors in this patient population,” the report stated. “Drug errors occurred mainly at the time of prescribing on admission, but were also detected throughout hospitalization and at discharge.”

The report found evidence that pharmacist involvement with hospitalized HIV patients reduces medication errors with this population. The report found, for example, that pharmacist-led medication reconciliation within 24 hours of admission significantly decreased medication errors when compared to nurse-led medication reconciliation that was later reviewed by a pharmacist.

“A review of patients by an infectious diseases clinical specialist at 48 hours postadmission found that error rates dropped from 52% during the period of nurse-led reconciliation to 5% after pharmacists began leading the medication reconciliation.”

The report also found that pharmacists played a key role in detecting medication errors with HIV hospitalized patients, with one study indicating pharmacist involvement with this patient population decreased the time in which antiretroviral medication errors were spotted and corrected from 84 hours to 15.5 hours.

“It can be concluded that initial medication reconciliation within 24 hours of admission, preferably by a designated HIV or infectious diseases pharmacist, along with continual monitoring throughout the hospitalization and at discharge is the optimal way to achieve timely error correction,” the report stated.

The report concluded that significant reductions in medication errors involving hospitalized HIV patients can be accomplished through accurate medication reconciliation, daily reviews of medical profiles, pharmacist communication during transitions of care, and the involvement of a HIV/infectious diseases clinical pharmacist.

“With the growing number of antiretrovirals and increasing complexity of therapy, it is our hope that this information will highlight the important role the pharmacist has in optimizing care to hospitalized HIV patients and provide further insights into the types of medication errors that occur and proposed solutions to curb these errors,” the report stated.