Impact of Pharmacy Technician-Centered Medication Reconciliation on Optimization of Antiretroviral Therapy and Opportunistic Infection Prophylaxis in Hospitalized Patients With HIV/AIDS

Abstract

Purpose: This study aimed to examine the role of a pharmacy technician-centered medication reconciliation (PTMR) program in optimization of medication therapy in hospitalized patients with HIV/AIDS. Methods: A chart review was conducted for all inpatients that had a medication reconciliation performed by the PTMR program. Adult patients with HIV and antiretroviral therapy (ART) and/or the opportunistic infection (OI) prophylaxis listed on the medication reconciliation form were included. The primary objective is to describe the (1) number and types of medication errors and (2) the percentage of patients who received appropriate ART. The secondary objective is a comparison of the number of medication errors between standard mediation reconciliation and a pharmacy-led program. Results: In the PTMR period, 55 admissions were evaluated. In all, 50% of the patients received appropriate ART. In 27of the 55 admissions, there were 49 combined ART and OI-related errors. The most common ART-related errors were drug–drug interactions. The incidence of ART-related medication errors that included drug–drug interactions and renal dosing adjustments were similar between the pre-PTMR and PTMR groups (P = .0868). Of the 49 errors in the PTMR group, 18 were intervened by a medication reconciliation pharmacist. Conclusion: A PTMR program has a positive impact on optimizing ART and OI prophylaxis in patients with HIV/AIDS.

Keywords

antiretroviral HIV/AIDS medication discrepancies medication errors medication reconciliation pharmacy technician

Get full access to this article

View all access options for this article.

References

Snyder

Klinker

Orrick

An in-depth analysis of medication errors in hospitalized patients with HIV. Ann Pharmacother. 2011;45(4):459–468.

Yehia

Mehta

Ciuffetelli

Antiretroviral medication errors remain high but are quickly corrected among hospitalized HIV-infected adults. Clin Infect Dis. 2012;55(4):593–599.

Arshad

Rothberg

Rastegar

Survey of physician knowledge regarding antiretroviral medications in hospitalized HIV-infected patients. J Int AIDS Soc. 2009;12(1):1–10.

Pastakia

Corbett

Raasch

Frequency of HIV-related medication errors and associated risk factors in hospitalized patients. Ann Pharmacother. 2008;42(4):491–497.

Corrigan

Atkinson

Sha

Evaluation of pharmacy-implemented medication reconciliation directed at antiretroviral therapy in hospitalized HIV/AIDS patients. Ann Pharmacother. 2010;44(1):222–223.

Carcelero

Tuset

Martin

Evaluation of antiretroviral-related errors and interventions by the clinical pharmacist in hospitalized HIV-infected patients. HIV Med. 2011;12(8):494–499.

Rao

patel

Grigoriu

Antiretroviral therapy prescribing in hospitalized HIV clinic patients. HIV Med. 2012;13(6):367–371.

Heelon

Skiest

Teresa

Effect of a clinical pharmacist’s interventions on duration of antiretroviral-related errors in hospitalized patients. Am J Health Syst Pharm. 2007;64(19):2064–2068.

Smith

Survey of FTE ID Pharmacists. Society of Infectious Diseases Pharmacy (SIDP), September 2011.

10.

Michels

Meisel

. Program using pharmacy technicians to obtain medication histories. Am J Health Syst Pharm. 2003;60(19):1982–1986.

11.

Van Den Bemt

Van Den Broek

Van Nunen

Medication reconciliation performed by pharmacy technicians at the time of preoperative screening. Ann Pharmacother. 2009;43(5):868–874.

12.

Johnston

Saulnier

Gould

. Best possible medication history in the emergency department: comparing pharmacy technicians and pharmacists. Can J Hosp Pharm. 2010;63(5):359–365.

13.

Panel on Antiretroviral Guidelines for Adults and Adolescents. Guidelines for the use of antiretroviral agents in HIV-1-infected adults and adolescents. Department of Health and Human Services. http://www.aidsinfo.nih.gov/contentfiles/lvguidelines/adultandadolescentgl.pdf. Accessed June 25, 2012.

14.

Panel on Antiretroviral Guidelines for Adults and Adolescents. Guidelines for the prevention and treatment of opportunistic infections in HIV-infected adults and adolescents. Department of Health and Human Services. http://www.aidsinfo.nih.gov/contentfiles/Adult_OI000999.pdf. Accessed November 10, 2011.

15.

Reyataz (atazanavir) [package insert]. New York, NY: Bristol-Myers Squibb; 2003.

16.

Viracept (nelfinavir) [package insert]. La Jolla, CA: Agouron Pharmaceuticals, Inc.; 1997.

17.

The Joint Commission. Hospital: 2012 national patient safety goals. http://www.jointcommission.org/assets/1/6/NPSG_Chapter_Jan2012_HAP.pdf. Accessed June 25, 2012.

18.

Daniels

Raasch

Corbett

. Implementation of targeted interventions to decrease antiretroviral-related errors in hospitalized patients. Am J Health Syst Pharm. 2012;69(5):422–430.