Detecting Adverse Drug Events by Trigger Tool at a Provincial Hospital in Thailand
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Abstract
Objective: To evaluate the use of trigger tools for detecting of adverse drug events (ADEs) by modifying the established US trigger tool which consisted of 24 triggers for determining frequencies and characteristics of ADEs in hospitalized patients. Methods: This research was an observational retrospective study collecting the data by reviewing medical records of all patients in medical wards of a provincial hospital located in central region during January and April 2011. A research pharmacist collected the data by systematically and manually reviewing medical records to identify ADE triggers. When a trigger was identified, the researchers determined whether ADEs occurred. Results: A total of 300 medical records were reviewed with 344 times of trigger identification consisting of 13 types of triggers. Forty seven out of 344 identified triggers indicated 33 ADEs in 31 patients. The rate of ADEs was 11.0 events per 100 admissions (95% CI 7.1-14.6) or 26.3 events per 1,000 patient-days (95% CI 17.3-35.3). Twelve ADEs or 36.4% (95% CI 19.6-53.2) were classified as preventable ADEs. Twenty four ADEs (72.7% of total ADEs) were related to hospital admission. The severity of 25 ADEs (75.8% of total ADEs) were categorized as F (“harm that contributed to or resulted in temporary harm to the patients and required initial or prolonged hospitalization”). Antidiabetic drugs and insulin were the most common drug group causing ADEs i.e., 10 out of 33 ADEs (30.3%). The most common ADEs were hypoglycemia encountered in 10 out of 33 ADEs (30.3%). Conclusions: The triggers need modification to accommodate the nature of identified ADEs by using more than one triggers and selecting the triggers that match the drug utilization and practice in the setting. This study revealed that trigger tool has a potential role in increasing ability to detect ADEs and the tool need further development to suit for the use in Thai patients.
Article Details
ผลการวิจัยและความคิดเห็นที่ปรากฏในบทความถือเป็นความคิดเห็นและอยู่ในความรับผิดชอบของผู้นิพนธ์ มิใช่ความเห็นหรือความรับผิดชอบของกองบรรณาธิการ หรือคณะเภสัชศาสตร์ มหาวิทยาลัยสงขลานครินทร์ ทั้งนี้ไม่รวมความผิดพลาดอันเกิดจากการพิมพ์ บทความที่ได้รับการเผยแพร่โดยวารสารเภสัชกรรมไทยถือเป็นสิทธิ์ของวารสารฯ
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