The use of global trigger tool for evaluating adverse drug events in hospitalized patients

Abstract

Objective To investigate the use of global trigger tool (GTT) for evaluating adverse drug events (ADE) in hospitalized patients. Methods Fourteen triggers were selected according to Institute for Healthcare Improvement Global Trigger Tool for Measuring Adverse Events and situation of medicine administration in China. Three hundred discharged patients' medical records, coming from hospital information system of the First Affiliated Hospital of Guangxi Medical University from January to December 2013, were selected randomly and examined. The records with positive triggers were filtered and analyzed on estimation and classification of ADE as well as damage of organ and system. The detection rate of triggers was calculated and compared with the voluntary reporting rate of ADE in the same year. Results A total of 300 patients were involved in the 300 records. Of them, there were 59 patients with positive triggers accounting for 19.67% and 72 cases with positive triggers including 48 patients with only one positive trigger, 9 patients with 2 positive triggers, and 2 patients with 3 positive triggers. The cases with positive triggers were analyzed on estimation of ADE. Sixty-four ADEs were confirmed and these ADEs involved 49 patients. The detection rate of ADE was 16.33% (49/300). The 64 ADEs contained 53 ADEs (82.81%) of level E, 6 ADEs (9.38%) of level F, and 5 ADEs (7.81%) of level H. The most common damage of organ was gastrointestinal system and a total of 21 cases developed gastrointestinal damages. The clinical manifestations were vomiting (20 cases) and diarrhea (1 case). The voluntary reporting rate of ADE in the same year was 0.43%(286/66 395), compared with the detection rate of triggers (16.33%), the difference was statistically significant (χ2=1 479.589, P<0.001). Conclusion Compared with the voluntary reporting rate, GTT could find more ADE. Key words: Drug-related side effects and adverse reactions; Medical records system, computerized; Global trigger tool