Antiretroviral medication prescribing errors are common with hospitalization of HIV-infected patients

Tessa Commers, Susan Swindells, Harlan Sayles, Alan E. Gross, Marcel P DeVetten, Uriel Sandkovsky

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

Objectives: Errors in prescribing antiretroviral therapy (ART) often occur with the hospitalization of HIV-infected patients. The rapid identification and prevention of errors may reduce patient harm and healthcare-associated costs. Methods:Aretrospective reviewof hospitalized HIV-infected patientswas carried outbetween1January2009and 31 December 2011. Errors were documented as omission, underdose, overdose, duplicate therapy, incorrect scheduling and/or incorrect therapy. The time to error correctionwas recorded. Relative risks (RRs)were computed to evaluate patient characteristics and error rates. Results: A total of 289 medication errors were identified in 146/416 admissions (35%). The most common was drug omission (69%). At an error rate of 31%, nucleoside reverse transcriptase inhibitors were associated with an increased risk of error when compared with protease inhibitors (RR 1.32; 95% CI 1.04-1.69) and co-formulated drugs (RR 1.59;95%CI 1.19-2.09). Of the errors,31%were corrected within the first 24 h, but over half (55%) were never remedied. Admissions with an omission error were 7.4 times more likely to have all errors corrected within 24 h than were admissions without an omission. Drug interactions with ART were detected on 51 occasions. For the study population (n=177), an increased risk of admission error was observed for black (43%) compared with white (28%) individuals (RR 1.53; 95% CI 1.16-2.03) but no significant differences were observed between white patients and other minorities or between men and women. Conclusion: Errors in inpatient ARTwerecommon, and the majoritywere never detected. The mostcommonerrors involved omission of medication, and nucleoside reverse transcriptase inhibitors had the highest rate of prescribing error. Interventions to prevent and correct errors are urgently needed.

Original languageEnglish (US)
Article numberdkt323
Pages (from-to)262-267
Number of pages6
JournalJournal of Antimicrobial Chemotherapy
Volume69
Issue number1
DOIs
StatePublished - Jan 1 2014

Fingerprint

Medication Errors
Hospitalization
HIV
Reverse Transcriptase Inhibitors
Nucleosides
Patient Harm
Therapeutics
Protease Inhibitors
Drug Interactions
Pharmaceutical Preparations
Health Care Costs
Inpatients
Population

Keywords

  • Antiretroviral therapy
  • Error correction
  • HIV medication errors

ASJC Scopus subject areas

  • Pharmacology
  • Microbiology (medical)
  • Infectious Diseases
  • Pharmacology (medical)

Cite this

Antiretroviral medication prescribing errors are common with hospitalization of HIV-infected patients. / Commers, Tessa; Swindells, Susan; Sayles, Harlan; Gross, Alan E.; DeVetten, Marcel P; Sandkovsky, Uriel.

In: Journal of Antimicrobial Chemotherapy, Vol. 69, No. 1, dkt323, 01.01.2014, p. 262-267.

Research output: Contribution to journalArticle

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abstract = "Objectives: Errors in prescribing antiretroviral therapy (ART) often occur with the hospitalization of HIV-infected patients. The rapid identification and prevention of errors may reduce patient harm and healthcare-associated costs. Methods:Aretrospective reviewof hospitalized HIV-infected patientswas carried outbetween1January2009and 31 December 2011. Errors were documented as omission, underdose, overdose, duplicate therapy, incorrect scheduling and/or incorrect therapy. The time to error correctionwas recorded. Relative risks (RRs)were computed to evaluate patient characteristics and error rates. Results: A total of 289 medication errors were identified in 146/416 admissions (35{\%}). The most common was drug omission (69{\%}). At an error rate of 31{\%}, nucleoside reverse transcriptase inhibitors were associated with an increased risk of error when compared with protease inhibitors (RR 1.32; 95{\%} CI 1.04-1.69) and co-formulated drugs (RR 1.59;95{\%}CI 1.19-2.09). Of the errors,31{\%}were corrected within the first 24 h, but over half (55{\%}) were never remedied. Admissions with an omission error were 7.4 times more likely to have all errors corrected within 24 h than were admissions without an omission. Drug interactions with ART were detected on 51 occasions. For the study population (n=177), an increased risk of admission error was observed for black (43{\%}) compared with white (28{\%}) individuals (RR 1.53; 95{\%} CI 1.16-2.03) but no significant differences were observed between white patients and other minorities or between men and women. Conclusion: Errors in inpatient ARTwerecommon, and the majoritywere never detected. The mostcommonerrors involved omission of medication, and nucleoside reverse transcriptase inhibitors had the highest rate of prescribing error. Interventions to prevent and correct errors are urgently needed.",
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AU - Commers, Tessa

AU - Swindells, Susan

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AU - Sandkovsky, Uriel

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N2 - Objectives: Errors in prescribing antiretroviral therapy (ART) often occur with the hospitalization of HIV-infected patients. The rapid identification and prevention of errors may reduce patient harm and healthcare-associated costs. Methods:Aretrospective reviewof hospitalized HIV-infected patientswas carried outbetween1January2009and 31 December 2011. Errors were documented as omission, underdose, overdose, duplicate therapy, incorrect scheduling and/or incorrect therapy. The time to error correctionwas recorded. Relative risks (RRs)were computed to evaluate patient characteristics and error rates. Results: A total of 289 medication errors were identified in 146/416 admissions (35%). The most common was drug omission (69%). At an error rate of 31%, nucleoside reverse transcriptase inhibitors were associated with an increased risk of error when compared with protease inhibitors (RR 1.32; 95% CI 1.04-1.69) and co-formulated drugs (RR 1.59;95%CI 1.19-2.09). Of the errors,31%were corrected within the first 24 h, but over half (55%) were never remedied. Admissions with an omission error were 7.4 times more likely to have all errors corrected within 24 h than were admissions without an omission. Drug interactions with ART were detected on 51 occasions. For the study population (n=177), an increased risk of admission error was observed for black (43%) compared with white (28%) individuals (RR 1.53; 95% CI 1.16-2.03) but no significant differences were observed between white patients and other minorities or between men and women. Conclusion: Errors in inpatient ARTwerecommon, and the majoritywere never detected. The mostcommonerrors involved omission of medication, and nucleoside reverse transcriptase inhibitors had the highest rate of prescribing error. Interventions to prevent and correct errors are urgently needed.

AB - Objectives: Errors in prescribing antiretroviral therapy (ART) often occur with the hospitalization of HIV-infected patients. The rapid identification and prevention of errors may reduce patient harm and healthcare-associated costs. Methods:Aretrospective reviewof hospitalized HIV-infected patientswas carried outbetween1January2009and 31 December 2011. Errors were documented as omission, underdose, overdose, duplicate therapy, incorrect scheduling and/or incorrect therapy. The time to error correctionwas recorded. Relative risks (RRs)were computed to evaluate patient characteristics and error rates. Results: A total of 289 medication errors were identified in 146/416 admissions (35%). The most common was drug omission (69%). At an error rate of 31%, nucleoside reverse transcriptase inhibitors were associated with an increased risk of error when compared with protease inhibitors (RR 1.32; 95% CI 1.04-1.69) and co-formulated drugs (RR 1.59;95%CI 1.19-2.09). Of the errors,31%were corrected within the first 24 h, but over half (55%) were never remedied. Admissions with an omission error were 7.4 times more likely to have all errors corrected within 24 h than were admissions without an omission. Drug interactions with ART were detected on 51 occasions. For the study population (n=177), an increased risk of admission error was observed for black (43%) compared with white (28%) individuals (RR 1.53; 95% CI 1.16-2.03) but no significant differences were observed between white patients and other minorities or between men and women. Conclusion: Errors in inpatient ARTwerecommon, and the majoritywere never detected. The mostcommonerrors involved omission of medication, and nucleoside reverse transcriptase inhibitors had the highest rate of prescribing error. Interventions to prevent and correct errors are urgently needed.

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KW - Error correction

KW - HIV medication errors

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