Evaluation of accuracy of ihi trigger tool in identifying adverse drug events: a prospective observational study
Autor(a) principal: | |
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Data de Publicação: | 2018 |
Outros Autores: | , , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Institucional da UFMG |
Texto Completo: | https://doi.org/10.1111/bcp.13665 http://hdl.handle.net/1843/40032 |
Resumo: | Aims: Adverse drug events (ADEs) can seriously compromise the safety and quality of care provided to hospitalized patients, requiring the adoption of accurate methods to monitor them. We sought to prospectively evaluate the accuracy of the triggers proposed by the Institute for Healthcare Improvement (IHI) for identifying ADEs. Methods: A prospective study was conducted in a public university hospital in 2015 with patients over the age of 18. Triggers proposed by IHI and clinical alterations suspected to be ADEs were searched daily. The number of days in which the patient was hospitalized was considered as unit of measure to evaluate the accuracy of each trigger. Results: A total of 300 patients were included in this study. Mean age was 56.3 years (standard deviation (SD) 16.0), and 154 (51.3%) were female. The frequency of patients with ADEs was 24.7% and with at least one trigger was 53.3%. From those patients who had at least one trigger, the most frequent triggers were antiemetics (57.5%) and 'abrupt medication stop' (31.8%). The sensitivity of triggers ranged from 0.3 to 11.8% and the positive predictive value ranged from 1.2 to 27.3%. Specificity and negative predictive value were greater than 86%. Most patients identified by the presence of triggers did not have ADEs (64.4%). No triggers were identified in 40 (38.5%) ADEs. Conclusions: IHI Trigger Tool did not show good accuracy in detecting ADEs in this prospective study. The adoption of combined strategies could enhance effectiveness in identifying patient safety flaws. Further discussion might contribute to improve trigger usefulness in clinical practice. |
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2022-03-11T19:10:33Z2022-03-11T19:10:33Z20188422522259https://doi.org/10.1111/bcp.136650306-5251http://hdl.handle.net/1843/40032Aims: Adverse drug events (ADEs) can seriously compromise the safety and quality of care provided to hospitalized patients, requiring the adoption of accurate methods to monitor them. We sought to prospectively evaluate the accuracy of the triggers proposed by the Institute for Healthcare Improvement (IHI) for identifying ADEs. Methods: A prospective study was conducted in a public university hospital in 2015 with patients over the age of 18. Triggers proposed by IHI and clinical alterations suspected to be ADEs were searched daily. The number of days in which the patient was hospitalized was considered as unit of measure to evaluate the accuracy of each trigger. Results: A total of 300 patients were included in this study. Mean age was 56.3 years (standard deviation (SD) 16.0), and 154 (51.3%) were female. The frequency of patients with ADEs was 24.7% and with at least one trigger was 53.3%. From those patients who had at least one trigger, the most frequent triggers were antiemetics (57.5%) and 'abrupt medication stop' (31.8%). The sensitivity of triggers ranged from 0.3 to 11.8% and the positive predictive value ranged from 1.2 to 27.3%. Specificity and negative predictive value were greater than 86%. Most patients identified by the presence of triggers did not have ADEs (64.4%). No triggers were identified in 40 (38.5%) ADEs. Conclusions: IHI Trigger Tool did not show good accuracy in detecting ADEs in this prospective study. The adoption of combined strategies could enhance effectiveness in identifying patient safety flaws. Further discussion might contribute to improve trigger usefulness in clinical practice.Objetivos: Os eventos adversos a medicamentos (EAMs) podem comprometer seriamente a segurança e a qualidade da assistência prestada aos pacientes hospitalizados, exigindo a adoção de métodos precisos para monitorá-los. Buscamos avaliar prospectivamente a acurácia dos rastreadores propostos pelo Institute for Healthcare Improvement (IHI) para a identificação de EAMs. Métodos: Foi realizado um estudo prospectivo em um hospital universitário público em 2015 com pacientes maiores de 18 anos. Os gatilhos propostos pelo IHI e as alterações clínicas suspeitas de EAM foram pesquisados diariamente. O número de dias em que o paciente esteve internado foi considerado como unidade de medida para avaliar a acurácia de cada rastreador. Resultados: Um total de 300 pacientes foram incluídos neste estudo. A média de idade foi de 56,3 anos (desvio padrão (DP) 16,0) e 154 (51,3%) eram do sexo feminino. A frequência de pacientes com EAMs foi de 24,7% e com pelo menos um gatilho foi de 53,3%. Dos pacientes que tiveram pelo menos um gatilho, os gatilhos mais frequentes foram antieméticos (57,5%) e 'parada abrupta de medicação' (31,8%). A sensibilidade dos gatilhos variou de 0,3 a 11,8% e o valor preditivo positivo variou de 1,2 a 27,3%. A especificidade e o valor preditivo negativo foram superiores a 86%. A maioria dos pacientes identificados pela presença de rastreadores não apresentava EAM (64,4%). Não foram identificados gatilhos em 40 (38,5%) ADEs. Conclusões: IHI Trigger Tool não mostrou boa acurácia na detecção de EAMs neste estudo prospectivo. A adoção de estratégias combinadas poderia aumentar a eficácia na identificação de falhas de segurança do paciente. Uma discussão mais aprofundada pode contribuir para melhorar a utilidade do gatilho na prática clínica.engUniversidade Federal de Minas GeraisUFMGBrasilFAR - DEPARTAMENTO DE PRODUTOS FARMACÊUTICOSMED - DEPARTAMENTO DE CLÍNICA MÉDICAMED - DEPARTAMENTO DE PROPEDÊUTICA COMPLEMENTARBritish journal of clinical pharmacologyEventos adversos a medicamentosEfeitos colaterais relacionados ao medicamento e reações adversasErros de medicaçãoGerenciamento de riscosFerramenta de gatilhoTrigger toolMedication errosAadverse reactionsRisk managementAdverse drug ebents drug-related side effectshospitaisEvaluation of accuracy of ihi trigger tool in identifying adverse drug events: a prospective observational studyAvaliação da precisão da ferramenta de gatilho ihi na identificação de eventos adversos a medicamentos: um estudo observacional prospectivoinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articlehttps://bpspubs.onlinelibrary.wiley.com/doi/10.1111/bcp.13665Maria Das Dores Graciano SilvaMaria Auxiliadora Parreiras MartinsLuciana de Gouvêa VianaLuiz Guilherme PassagliaRenata Rezende de MenezesJoão Antonio de Queiroz OliveiraJose Luiz Padilha da SilvaAntonio Luiz Pinho Ribeiroapplication/pdfinfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da UFMGinstname:Universidade Federal de Minas Gerais (UFMG)instacron:UFMGLICENSELicense.txtLicense.txttext/plain; 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dc.title.pt_BR.fl_str_mv |
Evaluation of accuracy of ihi trigger tool in identifying adverse drug events: a prospective observational study |
dc.title.alternative.pt_BR.fl_str_mv |
Avaliação da precisão da ferramenta de gatilho ihi na identificação de eventos adversos a medicamentos: um estudo observacional prospectivo |
title |
Evaluation of accuracy of ihi trigger tool in identifying adverse drug events: a prospective observational study |
spellingShingle |
Evaluation of accuracy of ihi trigger tool in identifying adverse drug events: a prospective observational study Maria Das Dores Graciano Silva Trigger tool Medication erros Aadverse reactions Risk management Adverse drug ebents drug-related side effects hospitais Eventos adversos a medicamentos Efeitos colaterais relacionados ao medicamento e reações adversas Erros de medicação Gerenciamento de riscos Ferramenta de gatilho |
title_short |
Evaluation of accuracy of ihi trigger tool in identifying adverse drug events: a prospective observational study |
title_full |
Evaluation of accuracy of ihi trigger tool in identifying adverse drug events: a prospective observational study |
title_fullStr |
Evaluation of accuracy of ihi trigger tool in identifying adverse drug events: a prospective observational study |
title_full_unstemmed |
Evaluation of accuracy of ihi trigger tool in identifying adverse drug events: a prospective observational study |
title_sort |
Evaluation of accuracy of ihi trigger tool in identifying adverse drug events: a prospective observational study |
author |
Maria Das Dores Graciano Silva |
author_facet |
Maria Das Dores Graciano Silva Maria Auxiliadora Parreiras Martins Luciana de Gouvêa Viana Luiz Guilherme Passaglia Renata Rezende de Menezes João Antonio de Queiroz Oliveira Jose Luiz Padilha da Silva Antonio Luiz Pinho Ribeiro |
author_role |
author |
author2 |
Maria Auxiliadora Parreiras Martins Luciana de Gouvêa Viana Luiz Guilherme Passaglia Renata Rezende de Menezes João Antonio de Queiroz Oliveira Jose Luiz Padilha da Silva Antonio Luiz Pinho Ribeiro |
author2_role |
author author author author author author author |
dc.contributor.author.fl_str_mv |
Maria Das Dores Graciano Silva Maria Auxiliadora Parreiras Martins Luciana de Gouvêa Viana Luiz Guilherme Passaglia Renata Rezende de Menezes João Antonio de Queiroz Oliveira Jose Luiz Padilha da Silva Antonio Luiz Pinho Ribeiro |
dc.subject.por.fl_str_mv |
Trigger tool Medication erros Aadverse reactions Risk management Adverse drug ebents drug-related side effects hospitais |
topic |
Trigger tool Medication erros Aadverse reactions Risk management Adverse drug ebents drug-related side effects hospitais Eventos adversos a medicamentos Efeitos colaterais relacionados ao medicamento e reações adversas Erros de medicação Gerenciamento de riscos Ferramenta de gatilho |
dc.subject.other.pt_BR.fl_str_mv |
Eventos adversos a medicamentos Efeitos colaterais relacionados ao medicamento e reações adversas Erros de medicação Gerenciamento de riscos Ferramenta de gatilho |
description |
Aims: Adverse drug events (ADEs) can seriously compromise the safety and quality of care provided to hospitalized patients, requiring the adoption of accurate methods to monitor them. We sought to prospectively evaluate the accuracy of the triggers proposed by the Institute for Healthcare Improvement (IHI) for identifying ADEs. Methods: A prospective study was conducted in a public university hospital in 2015 with patients over the age of 18. Triggers proposed by IHI and clinical alterations suspected to be ADEs were searched daily. The number of days in which the patient was hospitalized was considered as unit of measure to evaluate the accuracy of each trigger. Results: A total of 300 patients were included in this study. Mean age was 56.3 years (standard deviation (SD) 16.0), and 154 (51.3%) were female. The frequency of patients with ADEs was 24.7% and with at least one trigger was 53.3%. From those patients who had at least one trigger, the most frequent triggers were antiemetics (57.5%) and 'abrupt medication stop' (31.8%). The sensitivity of triggers ranged from 0.3 to 11.8% and the positive predictive value ranged from 1.2 to 27.3%. Specificity and negative predictive value were greater than 86%. Most patients identified by the presence of triggers did not have ADEs (64.4%). No triggers were identified in 40 (38.5%) ADEs. Conclusions: IHI Trigger Tool did not show good accuracy in detecting ADEs in this prospective study. The adoption of combined strategies could enhance effectiveness in identifying patient safety flaws. Further discussion might contribute to improve trigger usefulness in clinical practice. |
publishDate |
2018 |
dc.date.issued.fl_str_mv |
2018 |
dc.date.accessioned.fl_str_mv |
2022-03-11T19:10:33Z |
dc.date.available.fl_str_mv |
2022-03-11T19:10:33Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://hdl.handle.net/1843/40032 |
dc.identifier.doi.pt_BR.fl_str_mv |
https://doi.org/10.1111/bcp.13665 |
dc.identifier.issn.pt_BR.fl_str_mv |
0306-5251 |
url |
https://doi.org/10.1111/bcp.13665 http://hdl.handle.net/1843/40032 |
identifier_str_mv |
0306-5251 |
dc.language.iso.fl_str_mv |
eng |
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eng |
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British journal of clinical pharmacology |
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info:eu-repo/semantics/openAccess |
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openAccess |
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application/pdf |
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Universidade Federal de Minas Gerais |
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UFMG |
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Brasil |
dc.publisher.department.fl_str_mv |
FAR - DEPARTAMENTO DE PRODUTOS FARMACÊUTICOS MED - DEPARTAMENTO DE CLÍNICA MÉDICA MED - DEPARTAMENTO DE PROPEDÊUTICA COMPLEMENTAR |
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Universidade Federal de Minas Gerais |
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