Bronkhorst Elmien, Joseph-Busby Michè, Bezuidenhout Selente
Department of Clinical Pharmacy, Sefako Makgatho Health Sciences University, Pretoria, South Africa.
Department of Public Health and Pharmacy Management, Sefako Makgatho Health Sciences University, Pretoria, South Africa.
South Afr J HIV Med. 2024 Aug 1;25(1):1594. doi: 10.4102/sajhivmed.v25i1.1594. eCollection 2024.
The roll-out of antiretroviral medicines has improved life expectancy in people living with HIV (PLHIV). This has resulted in more patients being hospitalised for non-communicable diseases, increasing risk for medication errors (MEs). Pharmacists, through medication reconciliation, may identify and reduce MEs in this population.
To describe the importance of a pharmacist's involvement in identifying and quantifying types of MEs.
A quantitative, prospective observational study was conducted over 14 weeks. A pharmacist reviewed HIV-positive, hospitalised patients' files, using a data collection instrument, to determine the prevalence of MEs in PLHIV. The study pharmacist recommended appropriate actions to the prescriber to resolve MEs and documented resolution of the MEs.
The study population of = 180 patient files were reviewed 453 times, identifying 466 MEs. Medication errors included incorrect medication reconciliation from history (19; 4.1%), prescription omission (17; 3.7%), duplication of therapy (10; 2.2%), missed doses (265; 57.1%), incorrect dosing (103; 22.2%), incorrect administration frequency (2; 0.4%), incorrect duration of therapy (15; 3.2%) and drug-drug interactions (18; 3.9%). More than half (58.2%) of the MEs were resolved in less than 24 h, with involvement of the pharmacist.
This study demonstrates the magnitude of MEs experienced in hospitalised PLHIV and highlights the role clinical pharmacists play in identifying and resolving MEs to improve patient outcomes.
抗逆转录病毒药物的推广提高了艾滋病毒感染者(PLHIV)的预期寿命。这导致更多患者因非传染性疾病住院,增加了用药错误(MEs)的风险。药剂师通过用药核对,可能识别并减少该人群中的用药错误。
描述药剂师参与识别和量化用药错误类型的重要性。
进行了一项为期14周的定量前瞻性观察研究。一名药剂师使用数据收集工具审查艾滋病毒呈阳性的住院患者档案,以确定PLHIV中用药错误的发生率。研究药剂师向开处方者推荐适当措施以解决用药错误,并记录用药错误的解决情况。
对180份患者档案的研究人群进行了453次审查,识别出466例用药错误。用药错误包括既往用药核对不正确(19例;4.1%)、处方遗漏(17例;3.7%)、重复治疗(10例;2.2%)、漏服剂量(265例;57.1%)、剂量错误(103例;22.2%)、给药频率错误(2例;0.4%)、治疗持续时间错误(15例;3.2%)和药物相互作用(18例;3.9%)。超过一半(58.2%)的用药错误在药剂师的参与下在不到24小时内得到解决。
本研究证明了住院PLHIV中用药错误的严重程度,并强调了临床药剂师在识别和解决用药错误以改善患者结局方面所起的作用。