title: The clinical utility of HIV outpatient pharmacist prescreening to reduce medication error and assess adherence.
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).
authors.affiliation: NIHR Biomedical Research Centre, Royal Liverpool and Broadgreen University Hospital Trust.
authors.forename: K
authors.initials: K
authors.lastname: Seden
authors.forename: M
authors.initials: M
authors.lastname: Bradley
authors.forename: A R O
authors.initials: AR
authors.lastname: Miller
authors.forename: M B J
authors.initials: MB
authors.lastname: Beadsworth
authors.forename: S H
authors.initials: SH
authors.lastname: Khoo
mesh_terms: D000328:Adult; D000368:Aged; D044966:Anti-Retroviral Agents / Q000009:adverse effects / Q000627:therapeutic use*; D004347:Drug Interactions; D005260:Female; D015658:HIV Infections / Q000188:drug therapy*; D006801:Humans; D008297:Male; D055118:Medication Adherence; D008508:Medication Errors / Q000517:prevention & control*; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010044:Outpatient Clinics, Hospital; D010593:Pharmaceutical Services; D010595:Pharmacists; D024382:Professional Role; D012017:Referral and Consultation; D055815:Young Adult
chemical_list: D044966:Anti-Retroviral Agents
keywords: AIDS; HIV; adherence; antiretroviral therapy; drug–drug interactions; medication error; pharmacist