Evaluation of a strategy aimed at reducing errors in antiretroviral prescriptions for hospitalized HIV-infected patients.

OBJECTIVES: Errors are frequently made in the prescription of antiretroviral medication for hospitalized HIV-infected patients. We had for aim to evaluate the prescription of antiretroviral drug regimens at hospital admission and the impact of a strategy implemented to prevent errors. METHODS: HIV-infected patients managed by our hospital as outpatients and admitted between January 1, 2010, and December 31, 2010 (first period) and between February 1, 2011, and January 31, 2012 (second period) were included in the study. We retrospectively identified errors made in the prescription of antiretrovirals by comparing the drugs prescribed during hospitalization and the treatment documented in the outpatient file. During the second period, we implemented a strategy involving the pharmacist and the infectious disease specialist to reduce the number of errors. RESULTS: Thirty-five patients were treated during the first period for 56 admissions, and 43 patients for 77 admissions during the second one. We identified 39% of medication-related errors during the first period and 42% during the second one. The most common errors were drug omission, inappropriate dosage, or failure to adjust dosage for renal insufficiency. Our intervention, during the second period, allowed correcting 36% of errors. CONCLUSION: In our study, errors made in the prescription of antiretroviral medication were frequent and our intervention allowed correcting 36% of errors. Other strategies, such as consulting a clinical pharmacist on admission, or training prescribers should be considered.

[Home chemotherapy for lung cancer: a five year retrospective study]. / Chimiothérapie à domicile du cancer bronchique. Etude rétrospective sur cinq ans.

INTRODUCTION: We present the results of a five year retrospective study of chemotherapy delivered at home for patients suffering from non-small cell lung cancer. METHODS: In partnership with "hospital at home" we have developed mechanisms to improve safety: secured prescriptions, treatments confirmations transmitted by fax, designed specific chemotherapy file and approval of family doctor prior to administration. RESULTS: We treated 74 patients and administered 401 injections of which 72% were for Vinorelbine and 28% for Gemcitabine. These protocols corresponded to day 8 injections for Cisplatin-based double drug therapies in 47% of cases and to weekly single drug chemotherapies in 53%. CONCLUSIONS: Constraints regarding medical staff availability were exceeded by many advantages: better hospital bed management, guaranteed treatment, improvements in patients' quality of life and strengthening of links between hospital and community.