School of Pharmacy, University of Eastern Finland, P.O.B 1627, 70211, Kuopio, Finland.
Kuopio University Hospital, Kuopio, Finland.
Eur J Clin Pharmacol. 2023 May;79(5):617-625. doi: 10.1007/s00228-023-03469-5. Epub 2023 Mar 11.
The objective of this study is to describe and analyze adverse drug events (ADE) identified using the Global trigger tool (GTT) in a Finnish tertiary hospital during a 5-year period and also to evaluate whether the medication module of the GTT is a useful tool for ADE detection and management or if modification of the medication module is needed. A cross-sectional study of retrospective record review in a 450-bed tertiary hospital in Finland. Ten randomly selected patients from electronic medical records were reviewed bimonthly from 2017 to 2021. The GTT team reviewed a total of 834 records with modified GTT method, which includes the evaluation of possible polypharmacy, National Early Warning Score (NEWS), highest nursing intensity raw score (NI), and pain triggers. The data set contained 366 records with triggers in medication module and 601 records with the polypharmacy trigger that were analyzed in this study. With the GTT, a total of 53 ADEs were detected in the 834 medical records, which corresponds to 13 ADEs/1000 patient-days and 6% of the patients. Altogether, 44% of the patients had at least one trigger found with the GTT medication module. As the number of medication module triggers increased per patient, it was more likely that the patient had also experienced an ADE. The number of triggers found with the GTT medication module in patients' records seems to correlate with the risk of ADEs. Modification of the GTT could provide even more reliable data for ADE prevention.
本研究旨在描述和分析芬兰一家三级医院使用全球触发工具(GTT)在五年期间发现的药物不良事件(ADE),并评估 GTT 的药物模块是否是发现和管理 ADE 的有用工具,或者是否需要对药物模块进行修改。这是一项在芬兰一家 450 床位的三级医院进行的回顾性病历记录横断面研究。从 2017 年至 2021 年,每隔两个月从电子病历中随机选择 10 名患者进行审查。GTT 团队共审查了 834 份记录,采用改良的 GTT 方法,其中包括评估可能的多种药物治疗、国家早期预警评分(NEWS)、最高护理强度原始评分(NI)和疼痛触发因素。该数据集包含 366 份药物模块触发记录和 601 份多种药物治疗触发记录,本研究对这两部分记录进行了分析。使用 GTT,在 834 份病历中总共发现了 53 例 ADE,相当于每 1000 个患者日发生 13 例 ADE,占患者总数的 6%。总共,44%的患者至少有一个触发因素被 GTT 药物模块发现。随着每位患者药物模块触发因素数量的增加,患者发生 ADE 的可能性也越大。GTT 药物模块在患者记录中发现的触发因素数量似乎与 ADE 风险相关。对 GTT 的修改可以为 ADE 预防提供更可靠的数据。