Adverse drug events in Chinese elder inpatients: a retrospective review for evaluating the efficiency of the Global Trigger Tool

Nan Yu; Liuyun Wu; Qinan Yin; Shan Du; Xinxia Liu; Shan Wu; Rongsheng Tong; Junfeng Yan; Yuan Bian

doi:10.3389/fmed.2023.1232334

Adverse drug events in Chinese elder inpatients: a retrospective review for evaluating the efficiency of the Global Trigger Tool

Front Med (Lausanne). 2023 Sep 28:10:1232334. doi: 10.3389/fmed.2023.1232334. eCollection 2023.

Authors

Nan Yu^{1

2}, Liuyun Wu^{1

3}, Qinan Yin^{1

3}, Shan Du^{1

3}, Xinxia Liu^{1

3}, Shan Wu^{1

4}, Rongsheng Tong^{1

3}, Junfeng Yan^{1

3}, Yuan Bian^{1

3}

Affiliations

¹ Department of Pharmacy, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China.
² Chengdu First People's Hospital, Chengdu, China.
³ Personalized Drug Therapy Key Laboratory of Sichuan Province, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China.
⁴ Maternal and Child Health Hospital of Shuangliu District, Chengdu, China.

Abstract

Background: Elderly patients frequently experience a high incidence of adverse drug events (ADEs) due to the coexistence of multiple diseases, the combination of various medications, poor medication compliance, and other factors. Global Trigger Tool (GTT) is a new method for identifying ADEs, introducing the concept of a trigger, that is, clues including abnormal laboratory values, reversal drugs, and clinical symptoms that may suggest ADEs, and specifically locating information related to ADEs in the medical record to identify ADEs. The aim of this study was to establish a GTT-based trigger tool for adverse medication events in elderly patients and to investigate the risk variables associated with such events.

Methods: The triggers were identified by reviewing the frequency of ADEs in elderly patients in Sichuan, China, retrieving relevant literature, and consulting experts. A retrospective analysis was carried out to identify adverse medication occurrences among 480 elderly inpatients in Sichuan People's Hospital.

Results: A total of 56 ADEs were detected in 51 patients (10.62%), 13.04 per 1,000 patient days, and 11.67 per 100 admissions. The overall positive predictive value (PPV) of the triggers was 23.84, and 94.64% of ADEs caused temporary injury. Gastrointestinal system injury (27.87%) and metabolic and nutritional disorders (24.53%) were the primary organ-systems affected by ADEs. The majority of ADEs were caused by drugs used to treat cardiovascular diseases. 71.43% of ADE occurred within 2 days of administration and the risk factor analysis of ADE revealed that the number of medicines had a significant correlation.

Conclusion: This study demonstrated GTT's value as a tool for ADEs detection in elderly inpatients in China. It enhances the level of medication management and comprehensively reflects the situation of ADE of the elderly.

Keywords: Global Trigger Tool; adverse drug events; adverse drug reaction; medication management; retrospective study.

Grants and funding

This work has been funded by the National Key Research and Development Program of China (2020YFC2005500), the Sichuan Science and Technology Plan Project (2022NSFSC0818 and 2023NSFSC0685), Clinical Research and Transformation Project of Sichuan Provincial People’s Hospital (No. 2018LY09).