1495. Adherence to Antiretroviral Therapy in Hospitalized HIV-positive Patients
Session: Poster Abstract Session: HIV Adherence
Friday, October 28, 2016
Room: Poster Hall
Background: Adherence to antiretroviral therapy (ART) has been shown to decrease the likelihood of resistance, reduce viral loads, and improve outcomes in HIV-positive patients. Medication errors can lead to missed doses in hospitalized patients. However, there may be other reasons for missed doses in hospitalized patients receiving ART including medications being held prior to surgery or due to intestinal obstruction/ileus; patient refusal; and adverse events. The objective of this study was to identify the adherence rate for ART in hospitalized HIV-positive patients.

Methods: All adult HIV-positive patients admitted for ≥48 hours who received ART during their hospital stay were evaluated retrospectively (1/2015-8/2015). Adherence rate and reason for non-adherence were evaluated. The number and type of medication errors were also assessed.

Results: One-hundred and fifteen (115) admissions from 101 patients were included. The median age was 55 yrs (IQR 51-63 yrs). The median CD4 count and CD4 % were 447 cells/μL (IQR 210-641 cells/μL) and 22% (IQR 13-36%), respectively. 56% of patients had an undetectable HIV-1 RNA viral load (VL) and 26% had no documented HIV-1 RNA VL. The median length of stay was 4 days (IQR 3-7 days). The most common antiretrovirals prescribed were FTC/TDF (46%), RAL (47%), or DRV/r (24%). Only 14% of patients were receiving a single tablet regimen. The overall adherence rate was 91% for all patients who received ART during their hospitalization. Forty percent (40%) of treatment courses had at least one missed dose. The most common reason for a missed dose was patient refusal (39%), NPO status (28%) and delay in continuing outpatient regimen (17%). Forty-five percent (45%) of treatment courses had a prescribing error with incorrect frequency (30%), and incorrect dose (25%) being the most common errors. Medication errors were more likely to occur with multi-tablet regimens compared to single tablet regimens (89% vs. 11%). Most errors (76%) were corrected within 24 hours of prescribing.

Conclusion: Adherence rates may be lower than expected in hospitalized patients due to non-preventable interruptions in therapy. Non-adherence during hospitalization should be acknowledged as a contributing factor to overall adherence in HIV-positive patients receiving ART.

Arnold Decano, PharmD1, Yanina Dubrovskaya, PharmD1, Harold Horowitz, MD2, Dhara Mehta, PharmD3 and Marco R. Scipione, PharmD1, (1)Department of Pharmacy, NYU Langone Medical Center, New York, NY, (2)Infectious Diseases, New York University School of Medicine, New York, NY, (3)Department of Pharmacy, Bellevue Hospital Center, New York, NY


A. Decano, None

Y. Dubrovskaya, None

H. Horowitz, None

D. Mehta, None

M. R. Scipione, None

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