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ART medication errors prevalent among hospitalized patients with HIV
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SAN DIEGO — The results of several studies presented at ID Week 2012 highlighted the prevalence of antiretroviral medication errors for hospitalized patients with HIV, but they suggest that embracing electronic medical records and other interventions may help reduce these errors.
Elizabeth Neuner, PharmD, an infectious disease clinical pharmacist at the Cleveland Clinic, and colleagues studied the charts of 162 patients with HIV who were admitted to the hospital during a 10-month period in 2011. The found the rate of prescription errors for ART was 50%, and 65% of these were not resolved by the time of discharge.
Elizabeth Neuner
“Studies have been done investigating ART medical errors in hospitalized patients in the past; however, many were done before the era of electronic medical records and computerized physician order entries,” Neuner said during a press briefing. “Some of the rationale for the high rate of medication errors has to do with the complexity of regimens used to treat HIV. Another reason may be that with advances in HIV care, the management of HIV care has shifted from the inpatient setting to the primary care setting.”
Neuner said since the completion of the study, the clinic has implemented numerous quality improvement measures, such as education and focusing on transition of care from inpatient to outpatient. In addition, they have made adjustments for electronic medication records, as well as formed an interdisciplinary stewardship effort between infectious disease pharmacists and infectious disease physicians.
In another study, Jean Lee, PharmD, a clinical pharmacist for HIV medicine at Special Immunology Services at Saint Mary’s Health Care in Michigan, and colleagues evaluated the effect on medication errors when an HIV outpatient clinic actively maintained patients’ ART prescriptions in a major hospital’s electronic records system. They entered data about patients’ HIV regimens from the clinic into the hospital database, so that physicians there would have the current medications and proper doses.
With this intervention, the medication error rate decreased by 93% among clinic patients who were later admitted to the hospital. This decrease was sustained 6 months later. Throughout 2010, Lee and colleagues also provided education about the intervention to ED physicians, hospitalists and nursing and pharmacy staff.
“Because of multiple mistakes with HIV medications in patients admitted to our hospital, we realized that we needed a process change,” Lee said during the press briefing. “The intervention resulted in better care for our patients when they were hospitalized. We also found in a sample of 20 patients with HIV, the direct cost of medication errors fell by 85%. We demonstrated that we can improve patient safety and show a financial benefit.”
For more information:
Lee J. #36115.
Neuner E. #36170.
Both presented at: ID Week 2012; Oct. 16-19, 2012; San Diego.
Disclosure: Lee and Neuner report no relevant financial disclosures.