Methods: This quasi-experiment assessed adult patients with HIV who received ART, OI prophylaxis, or both from 12/1/14-2/28/17 (pre-intervention) or 12/1/17-2/28/18 (post-intervention). Pre-intervention patients were assessed retrospectively, verbal and written education were provided, then prospective audit and feedback was conducted for post-intervention patients. The primary outcome was rate of ART-related medication errors in the pre- versus post-intervention groups. Secondary outcomes included time to resolution of ART- and OI-related medication errors, OI-related medication errors, types of errors, rate of acceptance of recommendations, in-hospital mortality, length of stay, and 30-day readmission.
Results: Sixty-seven patients were included in each group (pre- and post-intervention). ART errors occurred in 44.8% and 32.8% (p = 0.156), respectively. OI prophylaxis errors occurred in 11.9% vs. 9% (p = 0.572), respectively. No difference was found in types of errors between groups, except medication omission decreased significantly in the post-intervention group (31.3% vs. 11.9%; p = 0.006). The number of pharmacist-based interventions increased in the post-intervention group (6.3% vs. 52.9%; p = 0.001). No statistical difference was found in average time to error resolution (72 vs. 48 hours; p = 0.123), but errors resolved during admission significantly increased (50% vs. 86.8%; p <0.001). No difference was found in rate of intervention acceptance, which was high in both groups.
Conclusion: In this quasi-experiment, ART and OI prophylaxis medication errors were numerically reduced in the pharmacist-led intervention period, and medication errors were resolved a day faster in the post-intervention period. Future interventions targeting prescribing errors upon admission include follow-up education and evaluation of medication reconciliation practices in HIV-infected patients.
M. J. B. Wingler,
K. E. Barber, None
J. L. Wagner, None