Evaluating the Impact of a Pharmacist-Led Antiretroviral Stewardship Program on Reducing Drug Interactions in HIV-Infected Patients

J Int Assoc Provid AIDS Care. 2016 Jan-Feb;15(1):84-8. doi: 10.1177/2325957415600700. Epub 2015 Aug 19.

Abstract

Purpose: To compare the number of antiretroviral-related clinically significant drug-drug interactions (CSDDIs) occurring in hospitalized patients that were intervened upon before and after Antiretroviral Stewardship Program (ARVSP) expansion and to classify the interventions made to prevent errors.

Methods: A retrospective chart review of adult patients treated with antiretroviral therapy (ART) and who were hospitalized from September 2012 to February 2013. A CSDDI was defined as requiring an alternative therapy, dose adjustment, or schedule modification. Findings were compared to a prior study.

Results: A total of 185 admissions were included and 76 CSDDIs were identified, 19 (25%) occurred after ART approval. The percentages of CSDDIs that occurred after ART approval and were intervened upon before and after ARVSP expansion were 43% and 95%, respectively (P<.001). An additional 80 other interventions were made by the ARVSP.

Conclusion: An ARVSP is critical in the prevention of CSDDIs and errors to improve safety in HIV-infected patients.

Keywords: HIV; antiretroviral; drug interactions; pharmacist; stewardship.

MeSH terms

  • Adult
  • Aged
  • Anti-HIV Agents / adverse effects*
  • Anti-HIV Agents / therapeutic use
  • Drug Interactions*
  • Female
  • HIV Infections / drug therapy*
  • HIV Infections / virology
  • HIV-1 / drug effects
  • HIV-1 / physiology
  • Hospitalization
  • Humans
  • Male
  • Middle Aged
  • Nigeria
  • Pharmacy / statistics & numerical data
  • Program Evaluation
  • Retrospective Studies
  • Viral Load / drug effects
  • Young Adult

Substances

  • Anti-HIV Agents