Comparison of Error Incidence Between Single-Tablet Versus Multiple-Tablet INSTI-Based Regimens in the Inpatient...

Area of Science:

• Infectious Diseases
• Pharmacology
• Hospital Pharmacy

Background:

• Antiretroviral therapy (ART) errors are common in hospitalized human immunodeficiency virus (HIV) patients, potentially causing treatment failure and toxicity.
• ART is available as single-tablet regimens (STRs) or multiple-tablet regimens (MTRs), but data on inpatient error rates based on tablet count is limited.

Purpose of the Study:

• To compare the incidence of medication errors between bictegravir-based single-tablet regimens (STRs) and dolutegravir-based multiple-tablet regimens (MTRs) in hospitalized adult patients with HIV.

Main Methods:

• A multicenter, retrospective, observational study evaluated 514 adult inpatients receiving ART for HIV.
• The primary outcome was the composite incidence of errors when ART was dispensed as an STR versus an MTR.
• Secondary endpoints included error types, time to correction, and pharmacist involvement.

Main Results:

• The composite error incidence was significantly lower in the STR group (23%) compared to the MTR group (31.5%; P = 0.029).
• Dose-related errors, particularly for renal or hepatic adjustments, were significantly higher in the MTR group.
• Approximately one error per encounter occurred in both groups, with a median correction time over one day.

Conclusions:

• Administering INSTI-based ART as STRs in inpatient settings may decrease medication errors and improve patient care.
• However, STRs may not fully address dosing errors in organ dysfunction, and increased vigilance is crucial when using MTRs.