Abstract
BackgroundAlthough there are systems for reporting adverse drug reactions (ADR), these safety events remain under reported. The low-cost, low-tech trigger tool method is based on the detection of events through clues, and it seems to increase the detection of adverse events compared to traditional methodologies. This study seeks to estimate the prevalence of adverse reactions to drugs in patients seeking care in the emergency department.MethodsRetrospective study from January to December, 2014, applying the Institute for Healthcare Improvement (IHI) trigger tool methodology for patients treated at the emergency room of a tertiary care hospital.ResultsThe estimated prevalence of adverse reactions in patients presenting to the emergency department was 2.3% [CI95 1.3% to 3.3%]; 28.6% of cases required hospitalization at an average cost of US$ 5698.44. The most common triggers were hydrocortisone (57% of the cases), diphenhydramine (14%) and fexofenadine (14%). Anti-infectives (19%), cardiovascular agents (14%), and musculoskeletal drugs (14%) were the most common causes of adverse reactions. According to the Naranjo Scale, 71% were classified as possible and 29% as probable. There was no association between adverse reactions and age and sex in the present study.ConclusionsThe use of the trigger tool to identify adverse reactions in the emergency department was possible to identify a prevalence of 2.3%. It showed to be a viable method that can provide a better understanding of adverse drug reactions in this patient population.
Highlights
There are systems for reporting adverse drug reactions (ADR), these safety events remain under reported
Inclusion criteria included the administration of specified trigger medications, drugs that might be given in response to suspected adverse reactions to other drugs
The following medications were used as triggers: antihistamines and anti-allergy medications that can be used in cases of anaphylactoid or allergic reactions: diphenhydramine, fexofenadine, methylprednisolone, hydrocortisone, and hydroxyzine
Summary
There are systems for reporting adverse drug reactions (ADR), these safety events remain under reported. This study seeks to estimate the prevalence of adverse reactions to drugs in patients seeking care in the emergency department. Adverse drug reaction (ADR) is the fifth leading cause of death among Americans, surpassed only by heart disease, stroke, cancer, and lung diseases [3, 4]. The economic consequences are still not well elucidated, but there are two points to consider: the cost related to treatment and the cost related to prevention. The cost estimate for treatment in the United States reaches $130 billion per there are systems to report ADRs, there is consistent under reporting. ADRs are important to detect and to report because the majority of them are considered preventable [13,14,15]
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