Heelon Mark, Skiest Daniel, Tereso Gary, Meade Lauren, Weeks Julia, Pekow Penelope, Rothberg Michael B
Baystate Medical Center (BMC), Springfield, MA 01199, USA.
Am J Health Syst Pharm. 2007 Oct 1;64(19):2064-8. doi: 10.2146/ajhp070072.
The effect of a clinical pharmacist's interventions on the duration of antiretroviral-related errors in hospitalized patients was studied.
Between August 4, 2005, and February 4, 2006, all patients at least 18 years of age who were admitted to a 651-bed tertiary care teaching hospital and prescribed highly active antiretroviral therapy (HAART) were identified by one clinical pharmacist. If a HAART error was suspected, the pharmacist intervened with the house staff or outpatient physician to discuss and resolve the problem. The pharmacist also retrospectively identified potential HAART errors among patients with human immunodeficiency virus (HIV) admitted between January 2 and June 30, 2005. HAART errors included the following: incomplete regimen, incorrect dosage, incorrect schedule, medication-disease interaction, incorrect formulation, incorrect antiretroviral, duplication of therapy, and drug-drug interaction. The duration of each error was measured from the time of the initial incorrect order until a correct order was placed or until the patient was discharged.
A total of 199 admissions for patients with an order for HAART were identified during the study periods. A total of 73 HAART errors were confirmed in 41 patients. The most common type of error was incomplete regimen. There was no significant difference in the frequency or type of prescribing when comparing the preintervention and intervention phases. The median length of time until an error was corrected, however, was significantly shorter during the intervention phase (15.5 hours) than the preintervention phase (84 hours) (p < 0.0001).
The duration of prescribing errors was decreased when a clinical pharmacist monitoring patients receiving HAART intervened to resolve errors.
研究临床药师干预对住院患者抗逆转录病毒相关用药错误持续时间的影响。
在2005年8月4日至2006年2月4日期间，一名临床药师识别出所有入住一家拥有651张床位的三级护理教学医院且年龄至少18岁并接受高效抗逆转录病毒治疗（HAART）的患者。如果怀疑存在HAART用药错误，药师会与住院医生或门诊医生进行干预，以讨论并解决问题。药师还回顾性地识别了2005年1月2日至6月30日期间入院的人类免疫缺陷病毒（HIV）患者中潜在的HAART用药错误。HAART用药错误包括以下几种：治疗方案不完整、剂量错误、给药时间表错误、药物与疾病相互作用、剂型错误、抗逆转录病毒药物错误、重复治疗以及药物相互作用。每个错误的持续时间从最初错误医嘱下达之时起，直至下达正确医嘱或患者出院。
在研究期间共识别出199例有HAART医嘱的患者入院情况。41例患者共确认了73例HAART用药错误。最常见的错误类型是治疗方案不完整。在比较干预前和干预阶段时，处方的频率或类型没有显著差异。然而，干预阶段错误得到纠正的中位时间（15.5小时）明显短于干预前阶段（84小时）（p<0.0001）。
当临床药师对接受HAART治疗的患者进行监测并干预以解决错误时，处方错误的持续时间会缩短。
