ART-Related Medication Errors Continue to Persist, Emphasize Need for ART Stewardship

People living with HIV who are on an antiretroviral therapy (ART) regimen are living longer, more fulfilling lives. Managing the disease while preventing resistance is critical to patient outcomes; however, ART-related medication errors can occur and lead to suboptimal therapy and in some cases treatment resistance.

In a new study, a team of investigators set out to identify the rate of ART-related medication errors among people living with HIV who were hospitalized. Secondary objectives of this research included type of errors, rate of error resolution prior to discharge, and risk factors of ART-related medication errors.

Results of the research were presented in a poster session at IDWeek 2019.

The investigators conducted a multicenter, retrospective cohort study assessing patients with HIV or AIDS, based on classification codes. Patients who were at least 18 years of age who were hospitalized between March 2016 and March 2018 were included. Exclusion criteria consisted of pregnancy or receipt of only intravenous zidovudine during hospitalization. A total of 400 patients were selected for inclusion.

Among the 400 patients, 203 ART-related medication errors occurred (mean 0.9 ± 1.2 errors per patient). More errors were documented in male patients (p = 0.01), along with individuals whose HIV status was known at admission (p < 0.05), and in patients with an undetectable viral load (p = 0.01). Approximately 30% of ART-related medication errors were resolved prior to the patient’s discharge.

The investigators found that the most common type of errors were incorrect scheduling and incorrect or incomplete regimen. Additionally, “incorrect schedule, incorrect or incomplete regimen, and clinically significant drug-drug interaction (DDI) were the most common medication errors that persisted at discharge. Among resolved errors, resolution of clinically significantly DDI or incorrect/incomplete ART were the most common interventions.”

Based on these results, the investigators conclude that ART-related medication errors continue occur in the hospital setting and frequently persist at discharge. Therefore, interventions should be developed to reduce errors on admission. The authors also note that antimicrobial stewardship programs can incorporate ART stewardship into program activities and work to reduce the number of errors during hospitalization and transition of care.

The poster, Evaluation and Predictors of Antiretroviral (ART)-Related Medication Errors in Hospitalized People Living With HIV, was presented on Friday, October 4, 2019, at IDWeek 2019 in Washington DC.