Featured Research

from universities, journals, and other organizations

Studies target high rates of HIV medication errors among hospitalized patients

Date:
October 19, 2012
Source:
Society for Healthcare Epidemiology of America
Summary:
New research concludes that despite advances in electronic medical records, mistakes are still commonly made in the prescription of antiretroviral medications for hospitalized HIV-positive patients. At the same time, a trio of studies suggests however, that electronic records in combination with increased clinical education can help to greatly decrease medical errors.

Research presented at IDWeek 2012™ concludes that despite advances in electronic medical records, mistakes are still commonly made in the prescription of antiretroviral medications for hospitalized HIV-positive patients. At the same time, a trio of studies suggests however, that electronic records in combination with increased clinical education can help to greatly decrease medical errors.

The three studies are among the significant research being discussed at the inaugural IDWeek meeting, taking place through October 21 in San Diego. With the theme Advancing Science, Improving Care, IDWeek will feature the latest science and bench-to-bedside approaches in prevention, diagnosis, treatment, and epidemiology of infectious diseases, including HIV, across the lifespan. More than 1,500 abstracts from national and international scientists will be highlighted over five days.

"Treatment of HIV infection is complex, involving the administration of multiple drugs that often have the potential for major interactions," noted Joel E. Gallant, MD, IDWeek chair for the HIV Medicine Association. "Hospitalized patients are at risk for serious medication errors, especially when drugs are added or changed by physicians without HIV expertise. These studies emphasize the critical importance of electronic medical records and early expert consultation in hospitalized HIV-infected patients to prevent dangerous and costly medication errors."

Antiretroviral therapy, or HAART, combines three to four powerful drugs to prevent HIV resistance. These drugs can cause toxicity and serious side effects and improper administration can also lead to decreased efficacy.

Two studies featured at IDWeek describe the challenges that hospitals face in ensuring that patients infected with HIV are not put at risk of treatment failure or drug toxicity through dosage, timing and/or other errors with these medications.

In one study, researchers at the Cleveland Clinic looked retrospectively at the charts for 162 admissions of HIV patients over a 10-month period in 2011. The rate of prescription errors in their HAART regimens was 50 percent, and two-thirds of those mistakes were not identified and resolved before the patients were discharged.

Lead researcher Elizabeth Neuner, PharmD, an infectious disease clinical pharmacist at the clinic, points to the changing nature of HIV care as one explanation. Many hospital physicians are less familiar with HAART regimens because so much HIV care is now administered in outpatient settings, she said.

"The number and complexity of medications used to treat HIV and an unfamiliarity with seeing patients with these medications can lead to errors," Neuner said.

Since the study, the Cleveland Clinic has implemented numerous quality improvement measures, including increased education about potential drug interactions with antiretroviral medications and greater coordination of care between inpatient and outpatient settings. The clinic also added dosing and frequency alerts to its electronic medical records system.

Similar error rates were seen over an 18-month period by the University of Chicago Medical Center. Researchers in this second study reviewed 155 HAART regimens, which had been evaluated within 24 hours of the patients' admission. Nearly half of the initial hospital-prescribed HAART regimens required intervention, most typically so that dosages could be modified.

Lead researcher Natasha Pettit, PharmD, a clinical pharmacy specialist with University of Chicago Medicine, suggests that teaching hospitals could have high error rates in part because their medical and pharmacy residents do not have much experience with HIV drugs early in their training. "A first-year resident may not know the nuances related to administering these medications appropriately," she said.

"Data indicate that hospitals need to provide additional educational trainings and create innovative ways to catch and prevent these errors," Pettit added. The University of Chicago Medical Center responded to the findings by developing dosing cards with cautions on drug interactions, timing recommendations and other safety points. They are planning a more detailed evaluation as a step toward modifying HAART medication order entry in their electronic records system.

A third study in Michigan looked at the impact on medication mistakes when an HIV outpatient clinic worked to actively maintain patients' antiretroviral prescriptions in a major hospital's electronic records system. The result: The error rate plunged -- by 93 percent -- among clinic patients who were later admitted to the hospital.

The approach required extensive preparation by Special Immunology Services, the HIV clinic at Saint Mary's Health Care. Although the two are affiliated, their electronic medical records systems don't communicate, and the drug records of nearly 900 clinic patients had to be individually uploaded and then continually updated in the hospital system. Through much of 2010, meetings followed with emergency room physicians. Educational notices went out through various hospital communications to other physicians, nurses, and other departments.

"It resulted in better care for our patients when they were hospitalized," said lead researcher Jean Lee, PharmD, a clinical pharmacist for HIV medicine at Special Immunology Services. In addition, based on a sample of 20 HIV-positive patients, the researchers found that the direct cost of medication errors fell by 85 percent. "We demonstrated that we can improve patient safety and show a financial benefit," said Lee.


Story Source:

The above story is based on materials provided by Society for Healthcare Epidemiology of America. Note: Materials may be edited for content and length.


Cite This Page:

Society for Healthcare Epidemiology of America. "Studies target high rates of HIV medication errors among hospitalized patients." ScienceDaily. ScienceDaily, 19 October 2012. <www.sciencedaily.com/releases/2012/10/121019130558.htm>.
Society for Healthcare Epidemiology of America. (2012, October 19). Studies target high rates of HIV medication errors among hospitalized patients. ScienceDaily. Retrieved September 22, 2014 from www.sciencedaily.com/releases/2012/10/121019130558.htm
Society for Healthcare Epidemiology of America. "Studies target high rates of HIV medication errors among hospitalized patients." ScienceDaily. www.sciencedaily.com/releases/2012/10/121019130558.htm (accessed September 22, 2014).

Share This



More Health & Medicine News

Monday, September 22, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Liberia Pleads for Help to Fight Ebola

Liberia Pleads for Help to Fight Ebola

AP (Sep. 22, 2014) Liberia's finance minister is urging the international community to quickly follow through on pledges of cash to battle Ebola. Bodies are piling up in the capital Monrovia as the nation awaits more help. (Sept. 22) Video provided by AP
Powered by NewsLook.com
Ebola Doctor Says Border Controls Critical

Ebola Doctor Says Border Controls Critical

AP (Sep. 22, 2014) A Florida doctor who helped fight the expanding Ebola outbreak in West Africa says the disease can be stopped, but only if nations quickly step up their response and make border control a priority. (Sept. 22) Video provided by AP
Powered by NewsLook.com
Global Ebola Aid Increasing But Critics Say It's Late

Global Ebola Aid Increasing But Critics Say It's Late

Newsy (Sep. 21, 2014) More than 100 tons of medical supplies were sent to West Africa on Saturday, but aid workers say the global response is still sluggish. Video provided by Newsy
Powered by NewsLook.com
Sierra Leone in Lockdown to Control Ebola

Sierra Leone in Lockdown to Control Ebola

AP (Sep. 21, 2014) Sierra Leone residents remained in lockdown on Saturday as part of a massive effort to confine millions of people to their homes in a bid to stem the biggest Ebola outbreak in history. (Sept. 20) Video provided by AP
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:

Strange & Offbeat Stories


Health & Medicine

Mind & Brain

Living & Well

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins