1446. ART? Call ASP: Antimicrobial Stewardship Medication Reconciliation of Antiretroviral Therapy During Transition of Care
Session: Poster Abstract Session: Antimicrobial Stewardship: Interventions
Saturday, October 10, 2015
Room: Poster Hall
Background: Antiretrovirals are considered high-alert medications due to the risk of causing significant patient harm when used in error.  Despite tremendous advances in the pharmacotherapeutic management of human immunodeficiency virus (HIV) and medication reconciliation processes, patients receiving antiretroviral therapy (ART) remain at high risk of prescribing errors, especially at the time of hospital admission.  We sought to evaluate the impact of an ART stewardship intervention upon transition of care in hospitalized patients with HIV infection prescribed ART.

Methods: We performed a single-center, prospective analysis to compare ART prescribing errors before and after the implementation of a multipronged ART stewardship initiative.  This process included medication reconciliation with community HIV providers, provider education, and electronic medical record antiretroviral profile and formulary updates.  Prospective review of ART was completed daily by the antimicrobial stewardship program (ASP) members, mediated between the patient’s outpatient clinic and primary hospital service.  The primary outcome measure was the number of encounters with a prescribing error.  The secondary outcome measure was time to error resolution.

Results: A total of 177 encounters in 116 patients were reviewed: 51 encounters in 31 patients pre-intervention; 126 encounters in 85 patients post-intervention.  The total number of encounters with an ART prescribing error decreased from 20/51 (39%) to 29/126 (23%) (p=0.040) post-intervention.  The types of errors were similar between groups, with the exception of those started on ART upon presentation but not receiving ART as an outpatient due to noncompliance (0 patients in the pre-intervention group vs 9 patients in the post-intervention group, p=0.007).  Similarly, the mean time to error resolution was significantly decreased from 4.05 days to 1.88 days (p<0.001).

Conclusion: The implementation of a multifaceted ART stewardship intervention significantly reduces ART related prescribing errors and time to error resolution; however, significantly more patients post-intervention were initiated on ART upon presentation despite not receiving therapy as an outpatient due to noncompliance.

Mary Staicu, Pharm.D.1, Mary Lourdes Brundige, PharmD1 and Maryrose Laguio, MD2, (1)Pharmacy, Rochester Regional Health, Rochester, NY, (2)Infectious Disease, Rochester General Hospital, Rochester, NY


M. Staicu, None

M. L. Brundige, None

M. Laguio, None

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