Use of a trigger tool to detect adverse drug reactions in an emergency department
Use of a trigger tool to detect adverse drug reactions in an emergency department
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DOI：
10.1186/s40360-017-0177-y
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发表时间：
2017-11-15
影响因子：
2.9
通讯作者：
Edmond, Michael B.
中科院分区：
文献类型：
--
作者：
de Almeida, Silvana Maria;Romualdo, Aruana;Edmond, Michael B.
背景：尽管有报告药物不良反应（ADR）的系统，但这些安全性事件仍报告不足。低成本、低技术触发工具方法基于通过线索检测事件，与传统方法相比，似乎增加了不良事件的检测。本研究旨在评估在急诊科就诊的患者中药物不良反应的患病率。方法：回顾性研究，2014年1月至12月，应用医疗保健改善研究所（IHI）触发工具方法，在三级医院急诊室治疗的患者。结果：在急诊科就诊的患者中，不良反应的估计患病率为2。3% [CI 95 1.3%至3.3%]; 28.6%的病例需要住院治疗，平均费用为5698.44美元。最常见的诱因是氢化可的松（57%的病例）、苯海拉明（14%）和非索非那定（14%）。抗感染药（19%）、心血管药物（14%）和肌肉骨骼药物（14%）是最常见的不良反应原因。根据纳兰霍量表，71%被归类为可能，29%被归类为很可能。不良反应与年龄和性别之间没有关联，在本study.Conclusions：使用触发工具，以确定在急诊室的不良反应是可能的，以确定患病率为2.3%。这是一种可行的方法，可以更好地了解该患者人群的药物不良反应。
Background: Although there are systems for reporting adverse drug reactions (ADR), these safety events remain under reported. The low-cost, low-tech trigger tool method is based on the detection of events through clues, and it seems to increase the detection of adverse events compared to traditional methodologies. This study seeks to estimate the prevalence of adverse reactions to drugs in patients seeking care in the emergency department.Methods: Retrospective study from January to December, 2014, applying the Institute for Healthcare Improvement (IHI) trigger tool methodology for patients treated at the emergency room of a tertiary care hospital.Results: The estimated prevalence of adverse reactions in patients presenting to the emergency department was 2. 3% [CI95 1.3% to 3.3%]; 28.6% of cases required hospitalization at an average cost of US$ 5698.44. The most common triggers were hydrocortisone (57% of the cases), diphenhydramine (14%) and fexofenadine (14%). Anti-infectives (19%), cardiovascular agents (14%), and musculoskeletal drugs (14%) were the most common causes of adverse reactions. According to the Naranjo Scale, 71% were classified as possible and 29% as probable. There was no association between adverse reactions and age and sex in the present study.Conclusions: The use of the trigger tool to identify adverse reactions in the emergency department was possible to identify a prevalence of 2.3%. It showed to be a viable method that can provide a better understanding of adverse drug reactions in this patient population.