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首页> 外文期刊>The annals of pharmacotherapy >Performance of the Adverse Drug Event Trigger Tool and the Global Trigger Tool for Identifying Adverse Drug Events: Experience in a Belgian Hospital
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Performance of the Adverse Drug Event Trigger Tool and the Global Trigger Tool for Identifying Adverse Drug Events: Experience in a Belgian Hospital

机译：不良药物事件触发工具和用于识别不良药物事件的全局触发工具的性能：比利时医院的经验

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Background: Medication-related harm can be detected using the adverse drug event (ADE) trigger tool and the medication module of the Global Trigger Tool (GTT) developed by the Institute for Healthcare Improvement (IHI). In recent years, there has been some controversy on the performance of this method. In addition, there are limited data on the performance of the medication module of the GTT as compared with the ADE trigger tool. Objectives: To evaluate the performance of the ADE trigger tool and of the medication module of the GTT for identifying ADEs. Methods: The methodology of the IHI was used. A random sample of 20 adult admissions per month was selected over a 12-month period in a teaching hospital in Belgium. The ADE trigger tool was adapted to the Belgian setting and included 20 triggers. The positive predictive value (PPV) of each trigger was calculated, as well as the proportion of ADEs that would have been identified with the medication module of the GTT as compared with the ADE trigger tool. Results: A total of 200 triggers and 62 ADEs were found, representing 26 ADEs/100 admissions. Nineteen ADEs (31%) were found spontaneously without the presence of a trigger. Three triggers never occurred. The PPVs of other triggers varied from 0 to 0.67, with half of them having PPVs less than 0.20. If we had used the medication triggers included in the GTT (n = 11), we would have identified 77% of total ADEs and 67% of preventable ADEs. Conclusions: Applying the trigger tool method proposed by the IHI to a Belgian hospital led to the identification of one ADE out of 4 admissions. To increase performance, refining the list of triggers in the ADE trigger tool and in the medication module of the GTT would be needed. Recording nontriggered events should be encouraged.
机译：背景：可以使用不良药物事件（ADE）触发工具和由医疗保健改善协会（IHI）开发的全局触发工具（GTT）的药物模块来检测与药物相关的伤害。近年来，这种方法的性能一直存在争议。此外，与ADE触发工具相比，有关GTT药物模块性能的数据有限。目的：评估ADE触发工具和GTT药物模块识别ADE的性能。方法：采用IHI方法。在比利时的一家教学医院中，在12个月内随机抽取了每月20名成人入院的样本。 ADE触发工具适用于比利时设置，包括20个触发。计算了每个触发的阳性预测值（PPV），以及与ADE触发工具相比，可以通过GTT的药物模块识别出的ADE的比例。结果：共发现200个触发器和62个ADE，代表26个ADEs / 100入场。在没有触发的情况下，自发发现了19个ADE（占31％）。从未发生过三个触发器。其他触发器的PPV在0到0.67之间变化，其中一半的PPV小于0.20。如果我们使用了GTT中包含的用药触发因素（n = 11），我们将确定77％的ADE和67％的可预防ADE。结论：将IHI提出的触发工具方法应用于比利时一家医院导致4例入院患者中识别出1例ADE。为了提高性能，需要完善ADE触发工具和GTT药物模块中的触发列表。应该鼓励记录未触发的事件。

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