The incidence and types of medication errors in patients receiving antiretroviral therapy in resource-constrained settings.
OBJECTIVE
This study assessed the incidence and types of medication errors, interventions and outcomes in patients on antiretroviral therapy (ART) in selected HIV treatment centres in Nigeria.


METHODS
Of 69 health facilities that had program for active screening of medication errors, 14 were randomly selected for prospective cohort assessment. All patients who filled/refilled their antiretroviral medications between February 2009 and March 2011 were screened for medication errors using study-specific pharmaceutical care daily worksheet (PCDW). All potential or actual medication errors identified, interventions provided and the outcomes were documented in the PCDW. Interventions included pharmaceutical care in HIV training for pharmacists amongst others. Chi-square was used for inferential statistics and P<0.05 indicated statistical significance.


RESULTS
Of 6,882 participants, 67.0% were female and 93.5% were aged ≥ 15 years old. The participants had 110,070 medications filling/refilling visits, average (± SD) of 16.0 (± 0.3) visits per patient over the observation period. Patients were followed up for 9172.5 person-years. The number of drug items dispensed to participants was 305,584, average of 2.8 (± 0.1) drug items per patient. The incidence rate of medication errors was 40.5 per 100 person-years. The occurrence of medication errors was not associated with participants' sex and age (P>0.05). The major medications errors identified were 26.4% incorrect ART regimens prescribed; 19.8% potential drug-drug interaction or contraindication present; and 16.6% duration and/or frequency of medication inappropriate. Interventions provided included 67.1% cases of prescriber contacted to clarify/resolve errors and 14.7% cases of patient counselling and education; 97.4% of potential/actual medication error(s) were resolved.


CONCLUSIONS
The incidence rate of medication errors was somewhat high; and majority of identified errors were related to prescription of incorrect ART regimens and potential drug-drug interactions; the prescriber was contacted and the errors were resolved in majority of cases. Active screening for medication errors is feasible in resource-limited settings following a capacity building intervention.
Howard University Pharmacists And Continuing Education (PACE) Center, Abuja, Nigeria.
Kenneth Anene
KA
Agu
Howard University Pharmacists And Continuing Education (PACE) Center, Abuja, Nigeria.
Dorothy
D
Oqua
Howard University Pharmacists And Continuing Education (PACE) Center, Abuja, Nigeria.
Zainab
Z
Adeyanju
Howard University Pharmacists And Continuing Education (PACE) Center, Abuja, Nigeria.
Muhammadu Alfa
MA
Isah
Howard University Pharmacists And Continuing Education (PACE) Center, Abuja, Nigeria.
Afusat
A
Adesina
Howard University Pharmacists And Continuing Education (PACE) Center, Abuja, Nigeria.
Samuel I
SI
Ohiaeri
Howard University Pharmacists And Continuing Education (PACE) Center, Abuja, Nigeria.
Pollock N
PN
Ali
Howard University Pharmacists And Continuing Education (PACE) Center, Abuja, Nigeria.
Nnenna
N
Ekechukwu
Howard University Pharmacists And Continuing Education (PACE) Center, Abuja, Nigeria.
Augustine Adah
AA
Akpakwu
Howard University Pharmacists And Continuing Education (PACE) Center, Abuja, Nigeria.
Tindak
T
Sani
Howard University Pharmacists And Continuing Education (PACE) Center, Abuja, Nigeria.
Idoko Onuche
IO
Omeh
Howard University College of Pharmacy, PACE Center, Washington DC, United States of America.
Rosalyn C
RC
King
Howard University College of Pharmacy, PACE Center, Washington DC, United States of America.
Anthony K
AK
Wutoh
D000293:Adolescent; D000328:Adult; D044966:Anti-Retroviral Agents / Q000627:therapeutic use*; D015331:Cohort Studies; D004347:Drug Interactions; D005260:Female; D015658:HIV Infections / Q000188:drug therapy*; D006268:Health Facilities / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D008297:Male; D008508:Medication Errors / Q000706:statistics & numerical data*; D009549:Nigeria
D044966:Anti-Retroviral Agents