Development of safety management system for Tenofovir disoproxil fumarate (TDF) in HIV patient at Klongluang Hospital Pathumthani province
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Abstract
Tenofovir disoproxil fumarate (TDF) is a standard antiretroviral agent for HIV treatment and prevention currently used in Thailand, although one critical side-effect is its renal toxicity. Development of a drug safety system for the hospital might prevent and alleviate problems related with TDF use. Objective: to develop a tenofovir safety management based on lean principle, medication reconciliation, and trigger tool. Materials and methods: This action research was done in HIV clinic at Klongluang Hospital. Deming cycle (PDCA) was used and composed of 4 steps (1) conducting an operational plan for HIV clinic by 12 multidisciplinary staffs (2) working followed the plan and collecting data in 189 patients between 1 October to 30 November 2017 (3) monitoring once a month for 2 consecutive months for service time, frequency of drug-related problem and number of medication error (4) announcing a new standard guideline for HIV clinic Result: outcomes were (1) reducing waiting time for laboratory service for 16.36 and 19.86 minutes, and reduced unnecessary cost for 1,470 and 1,680 baht in the first and second month, respectively (2) medication reconciliation presented (2.1) 1 undocumented intentional discrepancy and 2 unintentional discrepancies (2.2) 6 drug-related problems (2.3) 6 medication errors; 5 in B-level and 1 in D-level (3) trigger tool of crisis renal function was alarmed 19 times ; which were from 13 drug-related problems, 3 medication errors; 2 in B-level and 1 in E-level (4) this process was satisfied by 87.28% of staffs this plan was purposed to patient care team and then it was approved for using in HIV clinic. Conclusion: Tenofovir safety management could reduce waste and prevent risk of medication error.
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References
Bureau of Epidemiology Department of Disease Control. AIDS Situation of Thailand as of October 31, 2014. [Internet] 2015. [accessed on 10 April 2015]. Available from: https://www.boe.moph.go.th/files/report/20141128_61345755.pdf
Phakicheep S, Prakaeko K, Rakhakanakul R, Inkan P, Nakpaijit J, Laowahutanont T, et al. Handbook for Management of HIV/AIDS Patients. Bangkok: Rungsilp Publishing, 2007.
Sonthisombat P, Pattarachaiakul S, Manatatikul P, Santimaleevorakul V. Handbook for Pharmacists Care for HIV and AIDS Patients. Bangkok: Public Company Limited; 2012.
Department of Disease Control. Guidelines for the treatment and prevention of HIV infection in Thailand, 2014. 1st edition. Bangkok: The Agricultural Printing Company of Thailand Limited; 2014.
Fernandez-Fernandez B, Montoya-Ferrer A, Sanz AB, Sanchez-Niño MD, Izquierdo MC, Poveda J, et al. Tenofovir Nephrotoxicity; 2011 update. AIDS res treat 2011; 2011: 1-11.
Cooper R, Wiebe N, Smith N, Keiser P, Naicker S, Tonelli M. Systemic Review and Meta-Analysis: Renal Safety of Tenofovir Disoproxil Fumarate in HIV Infected Patients. Clin Infect Dis 2010; 51(5): 496-505.
Karras A, Lafauri M, Furco A, Bourgarit A, Droz D, Sereni D, et al. Tenofovir-Related Nephrotoxicity in Human Immunodeficiency Virus-Infected Patients: Three Cases of Renal Failure, Fanconi Syndrome, and Nephrogenic Diabetes Insipidus. Clin Infect Dis 2003; 36(8): 1070-3.
Kalayjian RC, Lau B, Mechekano RN, Crane HM, Rodriguez B, Salata RA, et al. Risk Factors for Chronic Kidney Disease in a Large Cohort of HIV-1 Infected Individuals Initiating Antiretroviral Therapy in Routine Care. AIDS 2012; 26(15): 1907-15.
Thananchai K, Sadomwat N, Kammoon T. Incidence rate of the decline in renal function in the HIV-infected patients receiving tenofovir and non-tenofovir based regimens. [Pharmacy Bachelor] Chiang Mai; Chiang Mai University; 2013.
Pengthina P. Incidence and risk factors of renal dysfunction in HIV-infected adults receiving Tenofovir Disoproxil Fumarate (TDF). [Master of Pharmacy Thesis] Chiang Mai; Chiang Mai University; 2013.
Woratanarat K. Tenofovir Disoproxil Fumarate-associated Nephrotoxicity in Patients with AIDS at King Chulalongkorn Memorial Hospital. [Master of Science thesis] Bangkok; Chulalongkorn University; 2008.
Chaisiri K .Nephrotoxicities of Tenofovir on HIV-infected patients. [Master of Science thesis.] Bangkok; Chulalongkorn University; 2009.
Tansirisuttikul R, Wanasil N, Theppang K, Limpanyalert P, Winyawat C. Report review knowledge on the development of a system for patient safety. [Internet]. 2012. [Accessed on 10 April 2015] Available from: https://www.shi.or.th/upload/Download%20File/ศุกร์เสวนา%2056/FridaySem57/ทบทวนองค์ความรู้%20Patient%20S%20afety.doc
Edwards DW. The new economics for industry, government, education. 2nded. Cambridge: MIT Press, 2000.
Hemajutha A. High alert drug. 2nd edition. Bangkok: Faculty of Pharmacy, Chulalongkorn University, 2011.
Chumjit C, Umrampai Y. Medication Management System for Medication Safety in Hospital: An Analysis on Problems and Opportunity for Improvement. Thai Pharm Health Sci J 2009; 4 (1): 127-35.
Chayakul S. The study of toxicity effect from Tenofovir in HIV patients or Immunocompromised Ratchaphiphat hospital : Ratchaphiphat hospital medical Science department. [Internet]. 2010. [Accessed on 1 May 2016] Available form: https://www.msdbangkok.go.th/dowload%20file/Personal/Succeed/060156/siraporn.pdf
Yeesoonpan N, Tragulpiankit P, Kaeratigachakorn W, et al. Detecting Adverse Drug Events by Trigger Tools at a Provincial Hospital in Thailand. J Pharm Pract 2015; 7(2): 234-49.
Papsamoot N, Wajajamroen B, Thaipanich A, et al. Use of medication reconciliation in addition to Drug Use Counseling for Diabetic Out-patients. Thai Pharm Health Sci J 2012; 7(2): 73-7.
Kaemuang S, Kaeyuranont P, Chankong W. Outcomes of Process for Reducing Prescribing Errors in Patients to Control Blood Pressure at Thalang Hospital’s Hypertension Clinic in Phuket Province. Journal of Safety and Health 2012; 24(7): 41-53.
Petchkum P, Suphanchaimat R. Incidence and Associated Risk Factors of Nephrotoxicity due to Tenofovir in HIV-Infected Patients. J Health Sci 2016; 25 (1): 92-103.