Evaluation of Global trigger tool as a medication safety tool for adverse drug event detection—a cross-sectional study in a tertiary hospital

Valkonen, Ville; Haatainen, Kaisa; Saano, Susanna; Tiihonen, Miia

doi:10.1007/s00228-023-03469-5

Cited by 8 publications

(1 citation statement)

References 26 publications

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“…We included 43 [ 4 , 8 – 11 , 13 , 16 , 20 , 21 , 33 – 66 ] articles based on our inclusion criteria, with almost half of them addressing the triggers recommended in the white paper. A total of 41 triggers were identified from various sources, including the articles, the white paper, physiologic changes during pregnancy, the common ADEs of drugs administered to obstetric patients for specific conditions, the Williams Handbook of Obstetrics [ 67 ], the obstetric guidelines, and a study of ADEs of obstetric patients [ 28 ].…”

Section: Resultsmentioning

confidence: 99%

Establishing a trigger tool based on global trigger tools to identify adverse drug events in obstetric inpatients in China

Wu,

Yin,

et al. 2024

BMC Health Serv Res

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Background Pregnant women belong to the special population of drug therapy, and their physiological state, pharmacokinetics and pharmacodynamics are significantly different from the general population. Drug safety during pregnancy involves two generations, which is a hot issue widely concerned in the whole society. Global Trigger Tool (GTT) of the Institute for Healthcare Improvement (IHI) has been wildly used as a patient safety measurement strategy by several institutions and national programs, and the effectiveness had been demonstrated. But only one study reports the use of GTT in obstetric delivery until now. The aim of the study is to establish triggers detecting adverse drug events (ADEs) suitable for obstetric inpatients on the basis of the GTT, to examine the performance of the obstetric triggers in detecting ADEs experienced by obstetric units compared with the spontaneous reporting system and GTT, and to assess the utility and value of the obstetric trigger tool in identifying ADEs of obstetric inpatients. Methods Based on a literature review searched in PubMed and CNKI from January of 1997 to October of 2023, retrospective local obstetric ADEs investigations, relevant obstetric guidelines and the common adverse reactions of obstetric therapeutic drugs were involved to establish the initial obstetric triggers. According to the Delphi method, two rounds of expert questionnaire survey were conducted among 16 obstetric and neonatological physicians and pharmacists until an agreement was reached. A retrospective study was conducted to identity ADEs in 300 obstetric inpatient records at the Sichuan Academy of Medical Sciences & Sichuan Provincial People’s Hospital from June 1 to September 30, 2018. Two trained junior pharmacists analyzed the first eligible records independently, and the included records reviewed by trained pharmacist and physician to identify ADEs. Sensitivity and specificity of the established obstetric triggers were assessed by the number of ADEs/100 patients and positive predictive value with the spontaneous reporting system (SRS) and GTT. Excel 2010 and SPSS22 were used for data analysis. Results Through two rounds of expert investigation, 39 preliminary triggers were established that comprised four modules (12 laboratory tests, 9 medications, 14 symptoms, and 4 outcomes). A total of 300 medical records were reviewed through the obstetric triggers, of which 48 cases of ADEs were detected, with an incidence of ADEs of 16%. Among the 39 obstetric triggers, 22 (56.41%) were positive and 11 of them detected ADEs. The positive predictive value (PPV) was 36.36%, and the number of ADEs/100 patients was 16.33 (95% CI, 4.19–17.81). The ADE detection rate, positive trigger rate, and PPV for the obstetric triggers were significantly augmented, confirming that the obstetric triggers were more specific and sensitive than SRS and GTT. Conclusion The obstetric triggers were proven to be sensitive and specific in the active monitoring of ADE for obstetric inpatients, which might serve as a reference for ADE detection of obstetric inpatients at medical institutions.

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Section: Resultsmentioning

confidence: 99%

Establishing a trigger tool based on global trigger tools to identify adverse drug events in obstetric inpatients in China

Wu,

Yin,

et al. 2024

BMC Health Serv Res

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Prospective identification of medication harm in geriatric inpatients using a modified trigger tool

Wang,

Lam,

Falconer

et al. 2024

Pharmacy Practice and Res

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BackgroundMedication harm (MH) causes patient morbidity and is a major healthcare burden. Research into MH is growing, but effective methods to identify MH are debated. The prevalence of MH is often based on an incomplete, retrospective chart review or spontaneous reporting, reliant on busy clinicians. A practical and clinically relevant method to detect MH is required. A trigger tool (TT) offers a solution.AimTo evaluate a modified TT to prospectively detect MH and determine the prevalence and severity of MH in a geriatric population.MethodAn international TT was peer evaluated and modified for use in a geriatric ward of a quaternary hospital. Patients were recruited over a 6‐month period. The TT was applied to prospectively help identify MH, which was assessed for causality and severity. Positive predictive values (PPV) were estimated for each trigger to determine its sensitivity in identifying MH. Ethics approval was granted by the Metro South Human Research Ethics Committee (Reference no: HREC/2022/QMS/80654) and the study conforms to the Australian National Statement on Ethical Conduct in Human Research. Informed consent was obtained from all participants through completion of a written consent form, after a full explanation of the protocol design.ResultsFifty patients consented, of which 16 (32%) patients experienced one or more MH events. A total of 257 triggers were activated (mean of 5.14 per patient) and 31 (12%) predicted an event. Of the 31 events, 19 (61.3%) events were rated as mild and 12 (38.7%) events were rated as moderate to severe. The most common events were bleeding/large bruising, major constipation, diarrhoea, and vomiting. The triggers with the highest PPV included triggers T5 (bleeding/bruising), T9 (gastrointestinal disorders), and T11 (major constipation) with PPVs of 0.455, 0.238, and 0.286, respectively.ConclusionA modified TT helped to detect MH in a geriatric population and will aid in identifying events in future studies.

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Global Trigger Tool detects adverse drug events

2023

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Evaluation of Global trigger tool as a medication safety tool for adverse drug event detection—a cross-sectional study in a tertiary hospital

Cited by 8 publications

References 26 publications

Establishing a trigger tool based on global trigger tools to identify adverse drug events in obstetric inpatients in China

Establishing a trigger tool based on global trigger tools to identify adverse drug events in obstetric inpatients in China

Prospective identification of medication harm in geriatric inpatients using a modified trigger tool

Global Trigger Tool detects adverse drug events

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