Improvement in the detection of adverse drug events by the use of electronic health and prescription records: An evaluation of two trigger tools.
Purpose: To test if two of the adverse event triggers proposed by the Institute of Healthcare Improvement can detect adverse drug events (ADEs) in a UK secondary care setting, using an electronic prescribing and health record system. Methods: In order to identify triggers for over-anticoagulation an...
| Publicado en: | European Journal of Clinical Pharmacology Vol. 69; no. 2; pp. 255 - 260 |
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| Autores principales: | , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Springer Nature
Feb2013
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=104296651&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 104296651 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00316970 NP9 jtl: European Journal of Clinical Pharmacology issn: 00316970 maglogo: N pubinfo: dt: Feb2013 vid: 69 iid: 2 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 104296651 84944528 10.1007/s00228-012-1327-1 NLM22706621 104296651 ppf: 255 ppct: 5 formats: fmt: @attributes: type: P tig: atl: Improvement in the detection of adverse drug events by the use of electronic health and prescription records: An evaluation of two trigger tools. aug: au: Nwulu, Ugochi Nirantharakumar, Krishnarajah Odesanya, Rachel McDowell, Sarah Coleman, Jamie affil: Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham NHS Foundation Trust, Edgbaston Birmingham UK sug: subj: Adverse Drug Event Electronic Health Records Prescribing Patterns Health Information Systems Human United Kingdom Record Review Retrospective Design Algorithms Descriptive Statistics Data Analysis Software Confidence Intervals Analgesics, Opioid Administration and Dosage Warfarin Administration and Dosage Naloxone Administration and Dosage Medication Errors Analgesics, Opioid Adverse Effects Warfarin Adverse Effects Funding Source ab: Purpose: To test if two of the adverse event triggers proposed by the Institute of Healthcare Improvement can detect adverse drug events (ADEs) in a UK secondary care setting, using an electronic prescribing and health record system. Methods: In order to identify triggers for over-anticoagulation and potential opioid overdose and we undertook a retrospective review of electronic medical and prescription records from 54,244 hospital admissions over a 1-year period, alongside a review of medical incident reports. Once prescription data were linked to triggers and duplicates were removed, case note review eliminated the false positive ADEs. Additionally, we tested the use of an electronic algorithm for the International Normalized Ratio (INR) ≥6 trigger. Results: The INR ≥6 electronic trigger identified 46 potential ADEs and the naloxone electronic trigger identified 82 ADEs. Based on the available case note review, the INR ≥6 trigger had a positive predictive value (PPV) of 38 % (14/37) and the naloxone trigger had a PPV of 91 % (61/67). The electronic algorithm for the INR ≥6 trigger identified 12 ADEs, thus reducing the need of case note review. This was in comparison with one and two critical incidents reported in the trust medical incident reports system, which respectively related to over-coagulation with warfarin and over-sedation with opioid medication. Conclusions: We have integrated automated and manual methods of detecting ADEs using previously defined triggers. Incorporating electronic triggers in already established electronic health records with prescription and laboratory test data can improve the detection of ADEs, and potentially lead to methods to avert them. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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