The clinical utility of HIV outpatient pharmacist prescreening to reduce medication error and assess adherence

Int J STD AIDS. 2013 Mar;24(3):237-41. doi: 10.1177/0956462412472428. Epub 2013 May 6.

Abstract

Antiretroviral therapy (ART) is complex and has high propensity for medication error and drug-drug interactions (DDIs). We evaluated the clinical utility of pharmacist prescreening for DDIs, adherence to ART and medicines reconciliation prior to HIV outpatient appointments. A pharmacist took detailed medication histories and ART adherence assessments, then screened medication for DDIs. A template detailing current medication, potential DDIs and adherence was filed in the clinical notes and physicians were asked for structured feedback. Potential DDIs were observed in 58% of 200 patients, with 22 (9%) potential DDIs occurring with medication that was not previously recorded in the patients' notes. Of 103 physician responses, 61.2% reported that the pharmacist consultation told them something they did not know, and pharmacist consultants led to change in management in 13.6% of cases. Pharmacist consultations were more likely to add benefit in patients taking two or more concomitant medications in addition to ART (P = 0.0012).

Keywords: AIDS; HIV; adherence; antiretroviral therapy; drug–drug interactions; medication error; pharmacist.

Publication types

  • Evaluation Study

MeSH terms

  • Adult
  • Aged
  • Anti-Retroviral Agents / adverse effects
  • Anti-Retroviral Agents / therapeutic use*
  • Drug Interactions
  • Female
  • HIV Infections / drug therapy*
  • Humans
  • Male
  • Medication Adherence*
  • Medication Errors / prevention & control*
  • Middle Aged
  • Outcome Assessment, Health Care
  • Outpatient Clinics, Hospital
  • Pharmaceutical Services
  • Pharmacists*
  • Professional Role*
  • Referral and Consultation
  • Young Adult

Substances

  • Anti-Retroviral Agents