Testing of Trigger Tool for Adverse Drug Reaction Detection Developed for a Large Teaching Hospital in Thailand
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Abstract
Objective: To determine the ability to detect adverse drug reactions (ADRs) of the trigger tool by developed for medical patients in Ramathibodi Hospital. Methods: A retrospective study using chart review was conducted. Adult patients older than 18 years admitted at 4 general medical wards who were recorded as having new ADRs in database of ADR monitoring system in 2014 was included. ADR monitoring system were composed of spontaneous report and report from the monitoring of clinical pharmacists. The researchers collected the data to test the trigger tool developed from those proposed by the Adverse Drug Reaction Community of Pharmacy Practice (AdCoPT), a community of practitioners under the Association of Hospital Pharmacy Thailand. Trigger tool in the study was created by adding or deleting triggers for the use in university hospital such as pharmacogenetics test for serious drug hypersensitivity, combination of triggers, i.e., statin with rhabdomyolysis, therapeutic drug monitoring for medications with narrow therapeutic index, and voriconazole which its polymorphism related to drug levels. Results: ADR report in 4 medical wards involved 118 patients. Present ADR monitoring system identified 164 events, while the modified trigger tool uncovered 197 events with 34 additional events. The most frequent identified triggers were 155 provisional diagnosis, followed by 65 abrupt medication stop, 7 pharmacogenetics testing of HLA-B*5801, 4 elevated voriconazole levels The most frequent affected systems by ADRs were white cell disorders (20.2%), followed by skin and appendage disorders (17.2%), and metabolic and nutritional disorders (11.6%). Conclusion: Modified trigger tool related to ADRs was more effective in ADR detection leading to the reduction of ADR severity and prevention.
Article Details
ผลการวิจัยและความคิดเห็นที่ปรากฏในบทความถือเป็นความคิดเห็นและอยู่ในความรับผิดชอบของผู้นิพนธ์ มิใช่ความเห็นหรือความรับผิดชอบของกองบรรณาธิการ หรือคณะเภสัชศาสตร์ มหาวิทยาลัยสงขลานครินทร์ ทั้งนี้ไม่รวมความผิดพลาดอันเกิดจากการพิมพ์ บทความที่ได้รับการเผยแพร่โดยวารสารเภสัชกรรมไทยถือเป็นสิทธิ์ของวารสารฯ
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