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MARK HEELON, PHARM.D., is Clinical Medication Specialist, Clinical Pharmacy Services, and Assistant Adjunct Professor of Pharmacy Practice, Baystate Medical Center (BMC), Springfield, MA. DANIEL SKIEST, M.D., is Director, Adult HIV Program, BMC, and Associate Research Director, Community Research Initiative of New England, Springfield. GARY TERESO, PHARM.D., is Clinical Pharmacy Specialist, Critical Care, and Assistant Adjunct Professor of Pharmacy Practice, BMC. LAUREN MEADE, M.D., is Assistant Clinical Professor, School of Medicine, Tufts University, Boston, MA, and Associate Program Director, BMC. JULIA WEEKS, B.A., is Research Assistant, BMC. PENELOPE PEKOW, PH.D., is Assistant Professor, School of Public Health and Health Sciences, University of Massachusetts, Amherst, and Senior Research Biostatistician, BMC. MICHAEL B. ROTHBERG, M.D., M.P.H., is Associate Program Director, Department of Medicine, BMC, and Assistant Professor, School of Medicine, Tufts University.

Address correspondence to Dr. Heelon at Baystate Medical Center, 759 Chestnut Street, Springfield, MA 01199 (mark.heelon{at}bhs.org).

Purpose. The effect of a clinical pharmacist’s interventions on the duration of antiretroviral-related errors in hospitalized patients was studied. Methods. Between August 4, 2005, and February 4, 2006, all patients at least 18 years of age who were admitted to a 651-bed tertiary care teaching hospital and prescribed highly active antiretroviral therapy (HAART) were identified by one clinical pharmacist. If a HAART error was suspected, the pharmacist intervened with the house staff or outpatient physician to discuss and resolve the problem. The pharmacist also retrospectively identified potential HAART errors among patients with human immunodeficiency virus (HIV) admitted between January 2 and June 30, 2005. HAART errors included the following: incomplete regimen, incorrect dosage, incorrect schedule, medication–disease interaction, incorrect formulation, incorrect antiretroviral, duplication of therapy, and drug–drug interaction. The duration of each error was measured from the time of the initial incorrect order until a correct order was placed or until the patient was discharged. Results. A total of 199 admissions for patients with an order for HAART were identified during the study periods. A total of 73 HAART errors were confirmed in 41 patients. The most common type of error was incomplete regimen. There was no significant difference in the frequency or type of prescribing when comparing the preintervention and intervention phases. The median length of time until an error was corrected, however, was significantly shorter during the intervention phase (15.5 hours) than the preintervention phase (84 hours) (p < 0.0001). Conclusion. The duration of prescribing errors was decreased when a clinical pharmacist monitoring patients receiving HAART intervened to resolve errors. Index terms: Antiretroviral agents; Clinical pharmacists; Dosage; Drug interactions; Errors, medication; Formulations; HIV infections; Hospitals; Interventions; Rational therapy

 

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				S. D Pastakia, A. H Corbett, R. H Raasch, S. Napravnik, and T. A Correll Frequency of HIV-Related Medication Errors and Associated Risk Factors in Hospitalized Patients Ann. Pharmacother., April 1, 2008; 42(4): 491 - 497. [Abstract] [Full Text] [PDF]