Medication reconciliation by a pharmacist in patients with HIV on antiretroviral therapy: the needed balance of availability and expertise.

Medication reconciliation is an important process to help reduce medication errors.1,2 Based on our experience, pharmacists enhance the medication reconciliation process in this high-risk group. However, such interventions need to be carefully implemented. Pharmacy technicians, although readily available and potentially beneficial, may lack the necessary expertise with complicated ART regimens or multiple comorbidities because they are usually unable to critically evaluate for appropriateness.5 Pharmacy residents and non-ID/HIV-specialized pharmacists could fill the gap of availability, but they need to be properly trained on the disease and medication management. Initially, they should be allowed to shadow an experienced pharmacist, provided with a structured approach, and have access to a specialist in the field if one is available. We understand that not all institutions have the resources to hire full-time ID/HIV pharmacists; in that situation, involvement of trained general pharmacists will be helpful. Furthermore, having only ID/HIV-specialized pharmacists conduct medication reconciliation may lead to substandard care if one is unavailable on weekends or holidays. A more standardized and sustained effort is clearly needed.