Implementation of a comprehensive intervention focused on hospitalized patients with HIV by an existing stewardship program: successes and lessons learned

Background: Several national organizations have advocated for inpatient antiretroviral stewardship to prevent the consequences of medication-related errors. This study aimed to evaluate the impact of a stewardship initiative on outcomes in people with HIV (PWH). Methods: A pharmacist-led audit and r...

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Bibliographic Details
Published in:Therapeutic advances in infectious disease 2021, Vol.8
Main Authors: Roshdy, Danya, McCarter, Maggie, Meredith, Jacqueline, Jaffa, Rupal, Hammer, Katie, Santevecchi, Barbara, Rozario, Nigel, Campbell, Jamie, Leonard, Michael, Polk, Christopher
Format: Article
Language:English
Subjects:
Antiretroviral drugs
Antiretroviral therapy
Drug administration
HIV
Human immunodeficiency virus
Infectious diseases
Medical errors
Mortality
Original Research
Patient safety
Patients
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Summary:Background: Several national organizations have advocated for inpatient antiretroviral stewardship to prevent the consequences of medication-related errors. This study aimed to evaluate the impact of a stewardship initiative on outcomes in people with HIV (PWH). Methods: A pharmacist-led audit and review of adult patients admitted with an ICD-10 code for HIV was implemented to an existing antimicrobial stewardship program. A quasi-experimental, retrospective cohort study was conducted comparing PWH admitted during pre- and post-intervention periods. Rates of antiretroviral therapy (ART)-related errors and infectious diseases (ID) consultation with linkage to care were evaluated through selection of a random sample of patients receiving ART in each period. Length of stay (LOS) and mortality were assessed by analyzing all admissions in the post-intervention period. Clinical outcomes including LOS, 30-day all-cause hospital readmission, and in-hospital and 30-day mortality in the post-intervention group were stratified by patients not on ART, on ART at admission, and started on ART as a result of the intervention. Results: A total of 100 patients in the pre-intervention period and 103 patients in the post-intervention period were included to assess ART-related errors and linkage to care. A reduction in errors (70.0 versus 25.7%, p 
ISSN:2049-9361
2049-937X
DOI:10.1177/20499361211010590