Global Trigger Tool for Monitoring Adverse Drug Events in Elderly Patients

doi:10.19803/j.1672-8629.2021.01.11

Abstract

Abstract: Objective To evaluate the feasibility of global trigger tool (GTT) in monitoring adverse drug events in elderly patients.Methods Based on the triggers recommended by IHI Global Trigger Tool for Measuring Adverse Events and those used in domestic studies,and considering the scope of biochemical indexes,drug catalogues and prescription habits in the hospital,some triggers were adjusted.A total of 31 triggers were finally developed.The clinical records of 360 patients aged above 65 years and discharged from the Department of Geriatrics from December 26,2015 to December 25,2016 were randomly selected.These records were reviewed by GTT and related ADE were determined using the Naranjo method.All the ADE were evaluated for severity classification,drug classification and involved system - organs.Statistical analysis was conducted with SPSS software,version 21.0,for window.Results Among the 360 elderly patients,169 records were positive according to the GTT method,so the positive rate was 46.94%.Nineteen of the 31 triggers were positive.There were 98 ADE identified that involved 75 patients.The incidence of ADE was 20.83%.Ninety-seven cases were category E and one case was category F.A total of 9 classes of drugs were involved in ADE.The incidence of ADE induced by cardiovascular drugs was the highest (58.16%).Eleven system-organs were involved.The percentage of ADE related to metabolism and nutrition was 42.86%.Authenticity indexes of GTT included a sensitivity of 100.00%,a specificity of 67.02%,and a Youden's index of 0.67.As for reliability indexes,the consistency rate was 73.89%,Kappa value was 0.46 and PPV was 44.38%.Logistic regression analysis found that age,length of hospital stay,the number of medications,the number of positive triggers and the number of preexisting diseases were significantly correlated with ADE among the elderly patients.Conclusion The validity and reliability of GTT for monitoring ADE in elderly patients are good,and PPV is high,but some triggers need to be improved.

Key words: global trigger tool, triggers, Naranjo method, elderly patients, adverse drug event

CLC Number:

R994.1

ZHANG Weiwei, WANG Na. Global Trigger Tool for Monitoring Adverse Drug Events in Elderly Patients[J]. Chinese Journal of Pharmacovigilance, 2021, 18(1): 56-63.

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