Pharmacist-Led Antiretroviral Stewardship Program Cuts Errors by One-Third

A pharmacist-led antiretroviral stewardship program significantly reduced the number of uncorrected antiretroviral therapy errors at a 486-bed academic hospital in South Florida, according to study authors.

“The baseline percent of admissions with at least 1 medication error in the preintervention period was 55.5%, which falls within the range of 45%-72% reported by several other studies,” wrote researchers. “Our combination of passive interventions, education and guidance, and triweekly active surveillance paired with real-time intervention was able to reduce that percentage to 32.6% in the postintervention period.”

The 2-year study took place at Memorial Hospital West, Broward County, Florida, and included adults with HIV taking at least one antiretroviral medication admitted for inpatient care. Researchers retrospectively gauged the percentage of uncorrected antiretroviral therapy errors among 119 patients admitted during the first year.

During the second year, they prospectively audited antiretroviral therapy orders for a total of 129 patients after implementation of the stewardship program.

The antiretroviral stewardship program team included a pharmacy resident, a medical resident, a pharmacist trained in infectious disease/HIV care, and an infectious disease/HIV physician, as well as ancillary health care providers.

Between the pre-intervention and postintervention phases, uncorrected antiretroviral therapy errors dropped 33%, according to study authors.

Specifically, delay-in-therapy errors decreased 7.9%, from 30.1% before the antiretroviral stewardship program to 22.2% in its first year. The time to correction of any error shortened from 3.1 days to 1.8 days.

“Because health care resources are finite and focused on the acute care of hospitalized patients, this multidisciplinary practice model may provide a practical approach for similar institutions to improve antiretroviral stewardship surveillance in the inpatient setting,” wrote researchers.

Reference:
Bernard GB, Montalvo S, Ivancic S, et al. Implementation of a pharmacist-led ARVSP in an academic hospital to reduce ART errors. J Am Pharm Assoc. Published online June 14, 2022. doi:10.1016/j.japh.2022.06.003