[Update of triggers for detection of adverse drug events in hematologic patients].
Íris Pilegi DominguesMilene Rangel da CostaPublished in: Cadernos de saude publica (2023)
The use of triggers for the active search and detection of adverse drug events (ADEs) has been gaining ground within pharmacovigilance services. Thus, the main objective of the study was to propose a new list of triggers to be used in a center specialized in hematology in Rio de Janeiro, Brazil. The update of the list of triggers consisted of revising the current list, with the exclusion and inclusion of new triggers. To verify the performance of the new list of triggers, a cross-sectional study was conducted in which the new triggers were used to investigate the occurrence of ADEs in patients attended in the emergency unit or hospitalized from January to March 2022. For each suspected ADEs, the patient's profile and adverse drug reactions (ADRs) were characterized regarding causality and severity. The performance of the triggers and their ability to capture ADEs were estimated using the following indicators: frequency of the trigger per 100 medical records, frequency of ADEs per 100 records, and positive predictive value (PPV). To evaluate the overall performance of the proposed new list, the PPV was estimated. A total of 374 prescriptions for triggers were identified in 186 medical records. The most efficient in the detection of possible ADEs were: lidocaine, loperamide, bisacodyl, filgrastim and glycerin clyster. The overall PPV of the new suggested list was 48% versus 10% of the previous list. This study demonstrated the importance of an updated list of triggers for the monitoring of ADEs and improvement of the care provided.
Keyphrases
- adverse drug
- healthcare
- end stage renal disease
- emergency department
- electronic health record
- newly diagnosed
- primary care
- chronic kidney disease
- prognostic factors
- risk assessment
- drug induced
- public health
- peritoneal dialysis
- loop mediated isothermal amplification
- physical activity
- chronic pain
- health insurance
- affordable care act