Sam Aaseer Thamby, Lian Jessica Looi Li, Parasuraman Subramani
Unit of Pharmacy Practice, Faculty of Pharmacy, AIMST University, Bedong 08100, Kedah, Malaysia.
Unit of Pharmacology, Faculty of Pharmacy, AIMST University, Bedong 08100, Kedah, Malaysia.
J Basic Clin Pharm. 2015 Mar;6(2):64-8. doi: 10.4103/0976-0105.152095.
To retrospectively determine the extent and types of adverse drug events (ADEs) from the patient cases sheets and identify the contributing factors of medication errors. To assess causality and severity using the World Health Organization (WHO) probability scale and Hartwig's scale, respectively.
Hundred patient case sheets were randomly selected, modified version of the Institute for Healthcare Improvement (IHI) Global Trigger Tool was utilized to identify the ADEs; causality and severity were calculated utilizing the WHO probability scale and Hartwig's severity assessment scale, respectively.
In total, 153 adverse events (AEs) were identified using the IHI Global Trigger Tool. Majority of the AEs are due to medication errors (46.41%) followed by 60 adverse drug reactions (ADRs), 15 therapeutic failure incidents, and 7 over-dose cases. Out of the 153 AEs, 60 are due to ADRs such as rashes, nausea, and vomiting. Therapeutic failure contributes 9.80% of the AEs, while overdose contributes to 4.58% of the total 153 AEs. Using the trigger tools, we were able to detect 45 positive triggers in 36 patient records. Among it, 19 AEs were identified in 15 patient records. The percentage of AE/100 patients is 17%. The average ADEs/1000 doses is 2.03% (calculated).
The IHI Global Trigger Tool is an effective method to aid provisionally-registered pharmacists to identify ADEs quicker.
回顾性地确定患者病历中药物不良事件（ADEs）的范围和类型，并识别用药错误的促成因素。分别使用世界卫生组织（WHO）概率量表和哈特维希量表评估因果关系和严重程度。
随机抽取100份患者病历，使用医疗改进研究所（IHI）全球触发工具的修改版来识别ADEs；分别使用WHO概率量表和哈特维希严重程度评估量表计算因果关系和严重程度。
使用IHI全球触发工具共识别出153起不良事件（AEs）。大多数AE是由用药错误引起的（46.41%），其次是60起药物不良反应（ADRs）、15起治疗失败事件和7起过量用药病例。在153起AE中，60起是由ADR引起的，如皮疹、恶心和呕吐。治疗失败占AE的9.80%，过量用药占153起AE总数的4.58%。使用触发工具，我们在36份患者记录中检测到45个阳性触发因素。其中，在15份患者记录中识别出19起AE。AE/100患者的百分比为17%。平均ADEs/1000剂量为2.03%（计算得出）。
IHI全球触发工具是一种有效的方法，可帮助临时注册药剂师更快地识别ADEs。
