HIV Pharmacist's Impact on Inpatient Antiretroviral Errors

Objectives Transitions in care between out‐patient and in‐patient settings provide ample opportunity for medication errors to occur in HIV‐infected patients. The purpose of this study was to examine the effectiveness of an HIV pharmacist monitoring service in decreasing antiretroviral medication errors in a large south central teaching hospital in the USA. Methods A retrospective, observational study was conducted to examine the frequency of antiretroviral medication errors in HIV‐seropositive patients with hospital admissions between 1 September 2011 and 30 September 2013 at a single tertiary care centre in Oklahoma. Patient assignment to the 12‐month pre‐intervention and intervention study periods was determined by admission date. Demographic, laboratory, and in‐patient medication data were collected. Bivariate analyses were conducted using χ2 analysis with the Yates correction factor for continuity to examine frequencies in specific antiretroviral classes and error categories. A multivariable Poisson regression was employed to examine the frequency of medication errors before and after initiation of the pharmacist service. Results Medication errors were examined in a total of 330 patient admissions during the 2‐year study period. A multivariable‐adjusted decrease of 73.9% in the number of errors was observed between the pre‐intervention and intervention periods (P < 0.001). Patients on protease inhibitor regimens or with impaired renal function had 2.6‐fold and 2.8‐fold higher numbers of errors, respectively (P < 0.001). Conclusions HIV pharmacist monitoring can decrease medication errors in HIV‐infected patients as they transition between out‐patient and in‐patient care. Patients receiving protease inhibitor‐based therapy or with renal insufficiency are at higher risk for medication errors upon admission.