Department of Pharmacy, Gaston Memorial Hospital, Gastonia, NC, USA.
Ann Pharmacother. 2013 Jul-Aug;47(7-8):953-60. doi: 10.1345/aph.1R773. Epub 2013 Jun 4.
Treatment with highly active antiretroviral therapy (HAART) decreases morbidity and mortality associated with HIV infection. Unfortunately, HAART medication errors are prevalent in hospitalized patients with HIV infection. Appropriate regimen administration and adherence are essential for treatment success.
To assess the impact of pharmacist interventions on the rate of medication errors in HIV-infected hospitalized patients who had been prescribed HAART in the outpatient setting.
Hospitalized patients aged 18 years or older receiving HAART and/or opportunistic infection (OI) prophylaxis were screened for inclusion. Data collection for each enrolled patient included demographic information, pertinent laboratory results, and inpatient and outpatient medication regimens. Patient medication profiles were reviewed within 72 hours of admission. HAART and/or OI prophylaxis errors were classified by type and frequency. Following the pharmacist intervention, prescribers' responses to each recommendation and the estimated time per intervention were recorded.
Eighty-six patients were included in this investigation and 210 HAART and OI prophylaxis errors were documented. Of patients receiving HAART and/or OI prophylaxis, 54.7% had at least 1 medication error on admission. An average of 2.4 errors per patient was identified. Dose omission (45.5%) was the most common error type among combined HAART and OI prophylaxis regimens, followed by incorrect regimen (17.1%) and incorrect dose (15.1%). Prescribers accepted 90% of pharmacist recommendations. A pharmacist was able to amend 94.7% of correctable HAART errors, as well as 89.9% of correctable combined HAART and OI prophylaxis errors. An estimated 18.5 minutes of pharmacist time were spent per patient requiring an intervention.
A clinical pharmacist's targeted review of outpatient-prescribed HAART and/or OI primary prophylaxis regimens of hospitalized HIV-infected patients can reduce most medication errors during hospitalization.
高效抗逆转录病毒治疗（HAART）可降低与 HIV 感染相关的发病率和死亡率。不幸的是，感染 HIV 的住院患者中普遍存在 HAART 用药错误。适当的方案管理和坚持是治疗成功的关键。
评估药师干预对在门诊接受 HAART 治疗的 HIV 感染住院患者药物错误发生率的影响。
筛选出年龄在 18 岁或以上、正在接受 HAART 和/或机会性感染（OI）预防治疗的住院患者。为每位入组患者收集的资料包括人口统计学信息、相关实验室结果以及住院和门诊药物治疗方案。在患者入院后 72 小时内审查他们的药物治疗方案。根据类型和频率对 HAART 和/或 OI 预防治疗错误进行分类。在药师干预后，记录每位医生对每项建议的反应以及每次干预的估计时间。
本研究共纳入 86 例患者，共记录 210 例 HAART 和 OI 预防治疗错误。接受 HAART 和/或 OI 预防治疗的患者中，54.7%在入院时至少有一种药物错误。每位患者平均发现 2.4 种错误。在联合 HAART 和 OI 预防治疗方案中，最常见的错误类型是剂量遗漏（45.5%），其次是方案错误（17.1%）和剂量错误（15.1%）。90%的药师建议得到了医生的认可。药师能够纠正 94.7%的可纠正 HAART 错误，以及 89.9%的可纠正联合 HAART 和 OI 预防治疗错误。每位需要干预的患者估计需要 18.5 分钟的药师时间。
临床药师对门诊开具的 HAART 和/或 OI 初级预防治疗方案的针对性审查可以减少住院期间大多数药物错误。
