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1305. Use of a Clinical Pharmacist to Reduce Inpatient ART (Antiretroviral Therapy) Errors

BACKGROUND: Continuous antiretroviral therapy (ART) that results in viral suppression is the goal of therapy for people living with HIV (PLWH). This results in improved clinical outcomes and prevents transmission to partners. University Medical Center is an urban charity hospital that provides the m...

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Autores principales: Mitchner, DeMaurian, Richey, Lauren E
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6809416/
http://dx.doi.org/10.1093/ofid/ofz360.1168
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author Mitchner, DeMaurian
Richey, Lauren E
author_facet Mitchner, DeMaurian
Richey, Lauren E
author_sort Mitchner, DeMaurian
collection PubMed
description BACKGROUND: Continuous antiretroviral therapy (ART) that results in viral suppression is the goal of therapy for people living with HIV (PLWH). This results in improved clinical outcomes and prevents transmission to partners. University Medical Center is an urban charity hospital that provides the majority of inpatient care to PLWH in the city of New Orleans. HIV care providers noticed many ART errors during transitions of care, particularly during inpatient admissions. Impartial regimens and interactions can occur when non-HIV providers manage patients in the hospital leading to resistance and viral failure. METHODS: A clinical pharmacist was hired to improve the quality of HIV care, both in the inpatient and outpatient setting. An electronic medical records alert was created for any patient with HIV who was admitted to the hospital. The clinical pharmacist then reviewed the ART orders Monday through Friday and provided recommendations to the inpatient teams. Data on the frequency and types of errors on the medication administration record (MAR) were recorded. Data were collected for 6 months, from October 2018 to March 2019. Three-month data from October 2018 to December 2018 was compared with three-month data from January 2019 to March 2019 for quality improvement purposes. RESULTS: One hundred forty-eight people living with HIV were admitted to the hospital during the specified time period. A minority of the patients (25%) had a consult to an HIV Specialist. Eight (5%) were omission of ART (no regimen or partial regimen), 19 (13%) had food or drug interactions, and 14 (10%) had the incorrect ART regimen ordered. The clinical pharmacist was able to contact the inpatient team and have these errors corrected. There was a 20% decrease in the patients with errors in their inpatient ART order on the MAR during the review period, due to physicians and pharmacists proactively contacting the pharmacist prior to orders being placed and processed. CONCLUSION: Errors in ART in the inpatient setting are common. A clinical pharmacist intervention can successfully decrease ART errors as patients’ transition between inpatient and outpatient care. [Image: see text] DISCLOSURES: All authors: No reported disclosures.
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spelling pubmed-68094162019-10-28 1305. Use of a Clinical Pharmacist to Reduce Inpatient ART (Antiretroviral Therapy) Errors Mitchner, DeMaurian Richey, Lauren E Open Forum Infect Dis Abstracts BACKGROUND: Continuous antiretroviral therapy (ART) that results in viral suppression is the goal of therapy for people living with HIV (PLWH). This results in improved clinical outcomes and prevents transmission to partners. University Medical Center is an urban charity hospital that provides the majority of inpatient care to PLWH in the city of New Orleans. HIV care providers noticed many ART errors during transitions of care, particularly during inpatient admissions. Impartial regimens and interactions can occur when non-HIV providers manage patients in the hospital leading to resistance and viral failure. METHODS: A clinical pharmacist was hired to improve the quality of HIV care, both in the inpatient and outpatient setting. An electronic medical records alert was created for any patient with HIV who was admitted to the hospital. The clinical pharmacist then reviewed the ART orders Monday through Friday and provided recommendations to the inpatient teams. Data on the frequency and types of errors on the medication administration record (MAR) were recorded. Data were collected for 6 months, from October 2018 to March 2019. Three-month data from October 2018 to December 2018 was compared with three-month data from January 2019 to March 2019 for quality improvement purposes. RESULTS: One hundred forty-eight people living with HIV were admitted to the hospital during the specified time period. A minority of the patients (25%) had a consult to an HIV Specialist. Eight (5%) were omission of ART (no regimen or partial regimen), 19 (13%) had food or drug interactions, and 14 (10%) had the incorrect ART regimen ordered. The clinical pharmacist was able to contact the inpatient team and have these errors corrected. There was a 20% decrease in the patients with errors in their inpatient ART order on the MAR during the review period, due to physicians and pharmacists proactively contacting the pharmacist prior to orders being placed and processed. CONCLUSION: Errors in ART in the inpatient setting are common. A clinical pharmacist intervention can successfully decrease ART errors as patients’ transition between inpatient and outpatient care. [Image: see text] DISCLOSURES: All authors: No reported disclosures. Oxford University Press 2019-10-23 /pmc/articles/PMC6809416/ http://dx.doi.org/10.1093/ofid/ofz360.1168 Text en © The Author(s) 2019. Published by Oxford University Press on behalf of Infectious Diseases Society of America. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Abstracts
Mitchner, DeMaurian
Richey, Lauren E
1305. Use of a Clinical Pharmacist to Reduce Inpatient ART (Antiretroviral Therapy) Errors
title 1305. Use of a Clinical Pharmacist to Reduce Inpatient ART (Antiretroviral Therapy) Errors
title_full 1305. Use of a Clinical Pharmacist to Reduce Inpatient ART (Antiretroviral Therapy) Errors
title_fullStr 1305. Use of a Clinical Pharmacist to Reduce Inpatient ART (Antiretroviral Therapy) Errors
title_full_unstemmed 1305. Use of a Clinical Pharmacist to Reduce Inpatient ART (Antiretroviral Therapy) Errors
title_short 1305. Use of a Clinical Pharmacist to Reduce Inpatient ART (Antiretroviral Therapy) Errors
title_sort 1305. use of a clinical pharmacist to reduce inpatient art (antiretroviral therapy) errors
topic Abstracts
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6809416/
http://dx.doi.org/10.1093/ofid/ofz360.1168
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