Antiretroviral medication prescribing errors are common with hospitalization of HIV-infected patients

Received 28 May2013; returned 2 July 2013; revised 11 July 2013; accepted 18 July 2013Objectives: Errors in prescribing antiretroviral therapy (ART) often occur with the hospitalization of HIV-infectedpatients. The rapid identification and prevention of errors may reduce patient harm and healthcare-associatedcosts.Methods:AretrospectivereviewofhospitalizedHIV-infectedpatientswascarriedoutbetween1January2009and31 December 2011. Errors were documented as omission, underdose, overdose, duplicate therapy, incorrectschedulingand/orincorrecttherapy.Thetimetoerrorcorrectionwasrecorded.Relativerisks(RRs)werecomputedto evaluate patient characteristics and error rates.Results: A total of 289 medication errors were identified in 146/416 admissions (35%). The most common wasdrug omission (69%). At an error rate of 31%, nucleoside reverse transcriptase inhibitors were associated withanincreasedriskoferrorwhencomparedwithproteaseinhibitors(RR1.32;95%CI1.04–1.69)andco-formulateddrugs(RR1.59;95%CI1.19–2.09).Oftheerrors,31%werecorrectedwithinthefirst24 h,butoverhalf(55%)werenever remedied. Admissions with an omission error were 7.4 times more likely to have all errors corrected within24 h than were admissions without an omission. Drug interactions with ARTwere detected on 51 occasions. Forthe study population (n¼177), an increased risk of admission error was observed for black (43%) comparedwith white (28%) individuals (RR 1.53; 95% CI 1.16–2.03) but no significant differences were observed betweenwhite patients and other minorities or betweenmen and women.Conclusion:ErrorsininpatientARTwerecommon,andthemajoritywereneverdetected.Themostcommonerrorsinvolvedomissionofmedication,andnucleosidereversetranscriptaseinhibitorshadthehighestrateofprescribingerror. Interventionsto prevent and correct errors are urgently needed.Keywords: antiretroviral therapy, HIVmedication errors, errorcorrection