Impact of an antiretroviral stewardship strategy on medication error rates.

Autor: Shea KM; Innovative Delivery Solutions, Cardinal Health, Houston, TX. kate.shea@cardinalhealth.com., Hobbs AL; Baptist Memorial Hospital-Memphis, Memphis, TN., Shumake JD; Institute for Mental Health Research, University of Texas at Austin, Austin, TX., Templet DJ; Seton Healthcare Family, Austin, TX., Padilla-Tolentino E; Seton Healthcare Family, Austin, TX., Mondy KE; Dell Medical School, University of Texas at Austin, Austin, TX.
Jazyk: angličtina
Zdroj: American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists [Am J Health Syst Pharm] 2018 Jun 15; Vol. 75 (12), pp. 876-885. Date of Electronic Publication: 2018 May 02.
DOI: 10.2146/ajhp170420
Abstrakt: Purpose: The impact of an antiretroviral stewardship strategy on medication error rates was evaluated.
Methods: This single-center, retrospective, comparative cohort study included patients at least 18 years of age infected with human immunodeficiency virus (HIV) who were receiving antiretrovirals and admitted to the hospital. A multicomponent approach was developed and implemented and included modifications to the order-entry and verification system, pharmacist education, and a pharmacist-led antiretroviral therapy checklist. Pharmacists performed prospective audits using the checklist at the time of order verification. To assess the impact of the intervention, a retrospective review was performed before and after implementation to assess antiretroviral errors.
Results: Totals of 208 and 24 errors were identified before and after the intervention, respectively, resulting in a significant reduction in the overall error rate ( p < 0.001). In the postintervention group, significantly lower medication error rates were found in both patient admissions containing at least 1 medication error ( p < 0.001) and those with 2 or more errors ( p < 0.001). Significant reductions were also identified in each error type, including incorrect/incomplete medication regimen, incorrect dosing regimen, incorrect renal dose adjustment, incorrect administration, and the presence of a major drug-drug interaction. A regression tree selected ritonavir as the only specific medication that best predicted more errors preintervention ( p < 0.001); however, no antiretrovirals reliably predicted errors postintervention.
Conclusion: An antiretroviral stewardship strategy for hospitalized HIV patients including prospective audit by staff pharmacists through use of an antiretroviral medication therapy checklist at the time of order verification decreased error rates.
(Copyright © 2018 by the American Society of Health-System Pharmacists, Inc. All rights reserved.)
Databáze: MEDLINE
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