Pharmacist-led medication safety interventions to reduce long-acting injectable-related medication incidents during community-to-inpatient transitions of care

Long-acting injectable (LAI) antipsychotic formulations can improve outcomes related to poor adherence in psychiatric patients. However, LAIs are known to be high-risk medications that are prone to medication errors, especially during transitions of care. This is often due to incomplete or incorrect medication reconciliation, inadequate documentation, or lapses in communication. LAI-focused medication safety interventions were implemented at a 63-bed inpatient behavioral health facility within an academic medical center. The interventions consisted of performing routine pharmacist chart reviews with standardized communication procedures including an intradepartmental pharmacy handoff, development of a “last-dose verification” order question on order entry, and formulary adjustments to limit available LAI products to those with a lower risk of medication errors. A pre-post study evaluating these interventions over two 4-month periods saw a nonsignificant decrease in the number of LAI medication errors related to medication reconciliation that reached a patient from 4 in the pregroup to zero in the postgroup ( p = 0.12). These efforts resulted in cascading effects throughout the facility, culminating in multidisciplinary psychotropic stewardship efforts focused on LAIs during community-to-inpatient transitions of care to improve LAI medication safety.