Identification and Prevention of Antiretroviral Medication Errors at an Academic Medical Center

Abstract

Background Patients with human immunodeficiency virus (HIV) taking antiretroviral therapy are at an increased risk for medication-related problems when transitioning into the inpatient setting. Methodology A retrospective chart review was used to find common highly active antiretroviral therapy (HAART)-related medication problems for 50 adult and pediatric patients who were admitted during the calendar year 2007 with a diagnosis of HIV at a 478-bed academic medical center. The results from the retrospective review were used to design a pilot program that consisted of a pharmacist making interventions when potential medication-related problems were identified. Data were collected after implementation of the program to assess whether this corrective measure decreased medication concerns associated with HAART. Results Results from the retrospective review revealed that 24% of patients did not have a complete home medication list on admission. HAART was discontinued in 21 patients (42%) and, of these, 14 patients (67%) did not have an appropriate reason documented. Antiretroviral medications were not appropriately dosed and scheduled for 18% of patients. For patients managed by the pilot program, the documentation of home medication lists improved by 24% and matching inpatient orders to the patient's home regimens improved by 26%. Only 9% of the HIV patients admitted had their medications discontinued for more than 24 hours, and all of those patients had an appropriate reason documented. The rate at which antiretroviral medications were appropriately dosed and scheduled increased by 21%. Conclusion Pharmacists can play a vital role in reducing medication errors for HIV patients admitted to the hospital.