Impact of Stewardship Interventions on Antiretroviral Medication Errors in an Urban Medical Center: a Three Year, Multi-Phase Study.

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Impact of Stewardship Interventions on Antiretroviral Medication Errors in an Urban Medical Center: a Three Year, Multi-Phase Study.

Pharmacotherapy. 2016 Feb 1;

Authors: Zucker J, Mittal J, Jen SP, Cheng L, Cennimo D

Abstract
BACKGROUND: There is a high prevalence of HIV in Newark, New Jersey with University Hospital admitting approximately 600 HIV-infected patients per year. Medication errors involving antiretroviral therapy (ART) could significantly impact treatment outcomes. The goal of this study was to evaluate the effectiveness of various stewardship interventions in reducing the prevalence of prescribing errors involving ART.
METHODS: This was a retrospective review of all inpatients receiving ART for HIV treatment during three distinct six-month intervals over a three-year period. During the first year, the baseline prevalence of medication errors was determined. During the second year, physician and pharmacist education was provided and a computerized order entry system with drug information resources and prescribing recommendations was implemented. Prospective audit of ART orders with feedback was conducted in the third year. Analyses and comparisons were made across the three phases of this study.
RESULTS: Of the 334 patients with HIV admitted in the first year, 45% had at least one antiretroviral medication error and 38% had uncorrected errors at the time of discharge. Following education and computerized order entry, significant reductions in medication error rates were observed compared to baseline rates; 36% of 315 admissions had at least one error and 31% had uncorrected errors at discharge. While the prevalence of antiretroviral errors in year three was similar to year two (37% of 276 admissions), there was a significant decrease in the prevalence of uncorrected errors at discharge (12%) with the use of prospective review and intervention.
CONCLUSIONS: Interventions, such as education and guideline development, can aid in reducing ART medication errors, but a committed stewardship program is necessary to elicit the greatest impact. This article is protected by copyright. All rights reserved.

PMID: 26833760 [PubMed - as supplied by publisher]

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