An antiretroviral stewardship team can prevent medication errors when people living with HIV (PLWH) are admitted to a hospital, a single-site study published in Open Forum Infectious Diseases found.
Researchers analyzed 567 admissions of PLWH to Temple University Hospital in Philadelphia, Pennsylvania, in which an antiretroviral was ordered between July 2017 and June 2018. The stewardship team intervened 336 times to correct drug regimens or dosages, request lab tests, prevent drug interactions, or provide advice when the antiretrovirals a patient was taking weren’t on the hospital formulary.
The most common problem corrected was drug interactions (152 interventions), especially coadministration of polyvalent cation supplements and integrase strand transfer inhibitors (INSTI), or of acid-suppressing medication and rilpivirine or atazanavir. The supplements must be given at a different time than the INSTI, and proton pump inhibitors, a class of acid reducers, should not be used with certain antiretrovirals.
The study focused on potential cost savings (calculated to be an average of roughly $813 per intervention, with a total of $263,428 saved during the study period), but preventing HIV medication errors may also avoid HIV-related disease or even death, study authors noted. “Recognizing risk factors such as multitablet inpatient regimens, admission to the intensive care unit, care provided by a surgery service, and increased number of days reviewed may help prioritize HIV-infected patients at higher risk for error,” they concluded.