title: Antiretroviral medication prescribing errors are common with hospitalization of HIV-infected patients.
abstract: OBJECTIVE
  Errors in prescribing antiretroviral therapy (ART) often occur with the hospitalization of HIV-infected patients. The rapid identification and prevention of errors may reduce patient harm and healthcare-associated costs.
  
  
  METHODS
  A retrospective review of hospitalized HIV-infected patients was carried out between 1 January 2009 and 31 December 2011. Errors were documented as omission, underdose, overdose, duplicate therapy, incorrect scheduling and/or incorrect therapy. The time to error correction was recorded. Relative risks (RRs) were computed to evaluate patient characteristics and error rates.
  
  
  RESULTS
  A total of 289 medication errors were identified in 146/416 admissions (35%). The most common was drug omission (69%). At an error rate of 31%, nucleoside reverse transcriptase inhibitors were associated with an increased risk of error when compared with protease inhibitors (RR 1.32; 95% CI 1.04-1.69) and co-formulated drugs (RR 1.59; 95% CI 1.19-2.09). Of the errors, 31% were corrected within the first 24 h, but over half (55%) were never remedied. Admissions with an omission error were 7.4 times more likely to have all errors corrected within 24 h than were admissions without an omission. Drug interactions with ART were detected on 51 occasions. For the study population (n = 177), an increased risk of admission error was observed for black (43%) compared with white (28%) individuals (RR 1.53; 95% CI 1.16-2.03) but no significant differences were observed between white patients and other minorities or between men and women.
  
  
  CONCLUSIONS
  Errors in inpatient ART were common, and the majority were never detected. The most common errors involved omission of medication, and nucleoside reverse transcriptase inhibitors had the highest rate of prescribing error. Interventions to prevent and correct errors are urgently needed.
authors: Department of Internal Medicine and Division of Infectious Diseases, University of Nebraska Medical Center, Omaha, NE, USA.
authors: Tessa
authors: T
authors: Commers
authors: Susan
authors: S
authors: Swindells
authors: Harlan
authors: H
authors: Sayles
authors: Alan E
authors: AE
authors: Gross
authors: Marcel
authors: M
authors: Devetten
authors: Uriel
authors: U
authors: Sandkovsky
mesh_terms: D000328:Adult; D000368:Aged; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D011307:Drug Prescriptions / Q000706:statistics & numerical data*; D005260:Female; D015658:HIV Infections / Q000188:drug therapy*; D006302:Health Services Research; D006760:Hospitalization; D006801:Humans; D007297:Inpatients; D008297:Male; D008508:Medication Errors / Q000706:statistics & numerical data*; D008875:Middle Aged; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D019380:Anti-HIV Agents
keywords: HIV medication errors; antiretroviral therapy; error correction