Background Electronic health records systems facilitate reconciliation of patients’ medicines. However, chronic medicines prescribed by hospital physicians and dispensed only at hospitals such as HIV treatments, are not yet recorded in primary care records and sometimes the dose and frequency are not correctly recorded in patients’ medical histories when they enter hospital.
Purpose To describe and analyse the discrepancies in HIV chronic treatments prescribed by hospital practitioners at admission to hospital.
Materials and Methods From June to October 2012, data of patients admitted with antiretroviral medicines were collected. HIV patients admitted to the Infectious Diseases Service or treated chronically in other hospitals were excluded. The pharmacist compared the computerised prescriptions at admission with the current HIV treatment recorded in the pharmacy chronic prescriptions dispensed programme (Farhos). In the event of discrepancies the pharmacist informed the physician/nurse and corrected the order. Non-justified discrepancies were notified and classified as reconciliation errors.
Results 68 patients’ treatments were analysed (Average age: 46 years. 44 men, 24 women). 49 patients were admitted to the emergency ward (E) and 19 to other wards (O). The average HIV drugs per patient were 2.2. In 17 patients (25%) the treatment was not correct (22.5% of E and 31.5% of O).
23 discrepancies were found in 150 medicines (0.33 per patient). 12 of these were associated with darunavir (41.6% of darunavir treatments were wrong). Classified by reconciliation errors: dose/frequency incorrect (16), omission (5), wrong drug (2).
Conclusions Incorrect prescriptions at admission of chronic hospital medicines such as HIV treatments cause a great number of reconciliation errors. Complex regimes, such as those including darunavir, facilitate prescription errors. Until HIV medicines are recorded in patients’ primary care records or recording is complete in hospital medical histories, the pharmacy data and pharmacist interventions are needed to guarantee the correct treatment. Due to the results, HIV stock drugs were removed from the Emergency Service.
No conflict of interest.
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