A clinical pharmacist's targeted review of outpatient-prescribed HAART and/or OI primary prophylaxis regimens of hospitalized HIV-infected patients can reduce most medication errors during hospitalization.

The patient experience in the hospital has become an increasingly important measure of how well a healthcare system functions. Poor experiences as reported by patients have been associated with decreased compliance to medication instructions as well as increased recovery time from illness. While other studies have demonstrated the benefit of pharmacist counseling during patient discharge, the benefit of pharmacist intervention during the patient's hospital stay remains to be seen. This study was an institutional review board-approved pre-/post-analysis assessing patients' perception of medication communications during hospitalization in an academic teaching hospital. An attempt to counsel all patients newly admitted to the hospital was made by pharmacy personnel. Patients on general medical-surgical units participated in a brief, five-question survey prior to and following the pharmacy initiative. Overall, the patient satisfaction with medication communications increased significantly. Patients' increased satisfaction with communications about their medications was attributed to the expansion of patient counseling through the pharmacy department initiative.

The study results suggest that among patients whose 4-T's scores indicate a low probability of HIT, the results of subsequent ELISA testing for HIT antibodies are likely to be negative in about 8 of 10 cases.