Acute Care Management of the <scp>HIV</scp>‐Infected Patient: A Report from the <scp>HIV</scp> Practice and Research Network of the American College of Clinical Pharmacy

Durham, Spencer H.; Badowski, Melissa E; Liedtke, Michelle D.; Rathbun, R Chris; Fulco, Patricia Pecora

doi:10.1002/phar.1921

Cited by 11 publications

(19 citation statements)

References 76 publications

(161 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, it is worth highlighting some specificities, such as phenytoin and dolutegravir that require a two-hour pause after their administration to ensure total absorption of the medication, with no interferences. 4,14 Among the medications with restrictions for administration via enteral feeding tubes, 35% (21) presented another administration alternative in the institution. Of these alternatives, 33.3% (7) were oral solutions or suspensions and 66.4% (14) were intravenous (IV) and intramuscular (IM) alternatives (Figure 1).…”

Section: Resultsmentioning

confidence: 99%

“…4,14 Among the medications with restrictions for administration via enteral feeding tubes, 35% (21) presented another administration alternative in the institution. Of these alternatives, 33.3% (7) were oral solutions or suspensions and 66.4% (14) were intravenous (IV) and intramuscular (IM) alternatives (Figure 1). Considering the data included in this study, it was possible to identify the prescription of medications (18.8%) contraindicated for administration via enteral feeding tubes.…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Evaluation of prescription containing medication via enteral feeding tubes in an adult emergency unit

Spezia¹,

Matheus²

2020

Rev Bras Farm Hosp Serv Saude

View full text Add to dashboard Cite

Objective: This study aims to evaluate medication prescriptions to be used by a feeding tube in an emergency unit, identify and classify the problems with the prescriptions and suggest interventions, done by a pharmacist, when necessary. Also aims to develop a guide with information about administering medication through the feeding tube in order to help the health care team. Methods: the study is characterized as a quantitative cross-sectional study, with data collected during March to September of 2019 at an adult emergency unit, a total of 47 prescriptions were analyzed by a pharmacist and 138 drugs were prescripted to be administered through a feeding tube. Results: A total of 18.8% of those medications presented some restriction to be administered by the feeding tube. The most common problems observed were the loss or reduction of therapeutic effect present in 61,6% of the cases, followed by drug-food interactions with 30.8%. About the pharmaceutical intervention more performed was requesting to change the pharmaceutical form (36%), followed by orientation about stop the enteral feeding (30.2%). To the elaboration of the guide for the health care team, 181 medications standardized at the hospital were analyzed, of that 33.1% presented some restriction to administer by feeding tube and only 35% presented another pharmaceutical form for substitution. Conclusion: it was possible to note the importance of pharmaceutical evaluation of prescriptions to identify errors and prevent future problems assuring the patient’s safety. The guide elaboration sought to assist and optimize the process of medication administration by feeding tube guaranteeing the safety and effectiveness of pharmacotherapy.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Evaluation of prescription containing medication via enteral feeding tubes in an adult emergency unit

Spezia¹,

Matheus²

2020

Rev Bras Farm Hosp Serv Saude

View full text Add to dashboard Cite

show abstract

“…If there were errors to ART and/or OI medication orders (ie, inpatient therapy ordered incorrectly compared with outpatient therapy), the HIV PharmD assisted with correcting these. In addition, HIV PharmD assisted with modifications to ART and/or OI medications warranted by changes in renal and hepatic function, drug interactions, and/or changes in oral access [ 23 , 24 ]. The HIV PharmD assisted with rapid initiation of ART, defined as ART initiation within 7 days of diagnosis, in newly diagnosed patients as well as reviewed accuracy of dosing of antimicrobials in patients presenting with concomitant OIs [ 25 ].…”

Section: Methodsmentioning

confidence: 99%

Impact of Pharmacist-Driven Antiretroviral Stewardship and Transitions of Care Interventions on Persons With Human Immunodeficiency Virus

Brizzi

Burgos

Chiampas

et al. 2020

Open Forum Infectious Diseases

View full text Add to dashboard Cite

Background Persons with human immunodeficiency virus (HIV) experience high rates of medication-related errors when admitted to the inpatient setting. Data are lacking on the impact of a combined antiretroviral (ARV) stewardship and transitions of care (TOC) program. We investigated the impact of a pharmacist-driven ARV stewardship and TOC program in persons with HIV. Methods This was a retrospective, quasi-experimental analysis evaluating the impact of an HIV-trained clinical pharmacist on hospitalized persons with HIV. Patients included in the study were adults following up, or planning to follow up, at the University of Illinois (UI) outpatient clinics for HIV care and admitted to the University of Illinois Hospital. Data were collected between July 1, 2017 and December 31, 2017 for the preimplementation phase and between July 1, 2018 and December 31, 2018 for the postimplementation phase. Primary and secondary endpoints included medication error rates related to antiretroviral therapy (ART) and opportunistic infection (OI) medications, all-cause readmission rates, medication access at time of hospital discharge, and linkage to care rates. Results A total of 128 patients were included in the study: 60 in the preimplementation phase and 68 in the postimplementation phase. After the implementation of this program, medication error rates associated with ART and OI medications decreased from 17% (10 of 60) to 6% (4 of 68) (P = .051), 30-day all-cause readmission rates decreased significantly from 27% (16 of 60) to 12% (8 of 68) (P = .03), and linkage to care rates increased significantly from 78% (46 of 59) to 92% (61 of 66) (P = .02). Conclusions A pharmacist-led ARV stewardship and TOC program improved overall care of persons with HIV through reduction in medication error rates, all-cause readmission rates, and an improvement in linkage to care rates.

show abstract

“…It is difficult to maintain a full stock of all HIV medications and formulations, which is a potential source of medication errors. [5][6][7] Unlike other disease states where automatic formulary interchange 856728P MTXXX10.1177/8755122519856728Journal of Pharmacy TechnologyWingler et al research-article2019 1 University of Mississippi Medical Center, Jackson, MS, USA 2 University of Mississippi School of Pharmacy, Jackson, MS, USA provides cost savings and similar patient outcomes, ART regimens are individualized to patients with HIV and should be continued as prescribed when patients are admitted to the hospital to decrease risk of errors at discharge. OI prophylaxis error rates have similar variability to ART errors, occurring between 10% and 77%.…”

Section: Introductionmentioning

confidence: 99%

“…5,[11][12][13] Correctly performing an admission medication reconciliation can have a major impact on medication errors 5,9,[13][14][15] ; however, ART can be affected by many factors during hospitalization, such as acute kidney injury, placement of an enteral feeding tube, or receipt of new medications that interact with the ART. 5,6 A study performed by Daniels et al 13 showed significant decreases in medication errors by providing education, performing admission medication reconciliation, reviewing ART therapy daily, and making specific updates to the computerized physician order entry (CPOE) system. This resulted in initial drug regimen errors decreasing from 72% to 15% and errors during hospitalizations from 84% to 6%.…”

Section: Introductionmentioning

confidence: 99%

An Evaluation of Pharmacist-Led Interventions for Inpatient HIV-Related Medication Errors

Wingler

Stover

Barber

et al. 2019

Journal of Pharmacy Technology

View full text Add to dashboard Cite

Background: Inpatient HIV-related medication errors occur in up to 86% of patients. Objective: To evaluate the number of antiretroviral therapy (ART)- and opportunistic infection (OI)-related medication errors following the implementation of pharmacist-directed interventions. Methods: This quasi-experiment assessed adult patients with HIV who received ART, OI prophylaxis, or both from December 1, 2014, to February 28, 2017 (pre-intervention) or December 1, 2017, to February 28, 2018 (post-intervention). Pre-intervention patients were assessed retrospectively; verbal and written education were provided (intervention); prospective audit and feedback was conducted for post-intervention patients. The primary outcome was rate of ART errors between groups. Secondary outcomes included rate of OI errors, time to resolution of ART and OI errors, types of errors, and rate of recommendation acceptance. Results: Sixty-seven patients were included in each group. ART errors occurred in 44.8% and 32.8% ( P = .156), respectively. OI prophylaxis errors occurred in 11.9% versus 9% ( P = .572), respectively. Medication omission decreased significantly in the post-intervention group (31.3% vs 11.9%; P = .006). Pharmacist-based interventions increased in the post-intervention group (6.3% vs 52.9%; P = .001). No statistical difference was found in time to error resolution (72 vs 48 hours; P = .123), but errors resolved during admission significantly increased (50% vs 86.8%; P < .001). No difference was found in rate of intervention acceptance (100% vs 97%). Conclusion and Relevance: ART and OI prophylaxis errors resolved a day faster in the pharmacist-led, post-intervention period, and there was a trend toward error reduction. Future interventions should target prescribing errors on admission using follow-up education and evaluation of medication reconciliation practices in HIV-infected patients.

show abstract

Acute Care Management of the HIV‐Infected Patient: A Report from the HIV Practice and Research Network of the American College of Clinical Pharmacy

Cited by 11 publications

References 76 publications

Evaluation of prescription containing medication via enteral feeding tubes in an adult emergency unit

Evaluation of prescription containing medication via enteral feeding tubes in an adult emergency unit

Impact of Pharmacist-Driven Antiretroviral Stewardship and Transitions of Care Interventions on Persons With Human Immunodeficiency Virus

An Evaluation of Pharmacist-Led Interventions for Inpatient HIV-Related Medication Errors

Contact Info

Product

Resources

About