Application of triggers to detect adverse drug events in hospitalized older people

• Grant number: 24/06310-6
• Support Opportunities: Scholarships in Brazil - Scientific Initiation
• Start date: July 01, 2024
• End date: February 28, 2026
• Field of knowledge: Health Sciences - Pharmacy
• Principal Investigator: Patricia de Carvalho Mastroianni
• Grantee: Heloisa Laurindo de Mendonça
• Host Institution: Faculdade de Ciências Farmacêuticas (FCFAR). Universidade Estadual Paulista (UNESP). Campus de Araraquara. Araraquara , SP, Brazil

Abstract

Introduction: Although the prevalence of adverse drug events (ADEs) in older people is higher when compared to younger people, this prevalence may be underestimated due to underdetection and underreporting of these adverse events. In this context, trigger tools can help the interprofessional team to detect, quantify and prevent ADEs, in addition to enabling the identification of risk factors associated with the occurrence of ADEs and their harm to the patient. Although evidence of the usefulness and performance of trigger tools retrospectively is established and presents satisfactory performance in recognizing ADEs, evidence on the application and performance of the tools prospectively is limited. Objective: To evaluate the usefulness and performance of the trigger tool developed by Thevelin et al. (2018) and validated by Zerah et al. (2022) for detecting ADEs in older people. Methodology: A pharmacoepidemiological study will be conducted with prospective data collection in a secondary hospital in the interior of São Paulo. Older people (e 60 years old) admitted for more than 24 hours will be eligible. Admissions for surgeries and elective health procedures will be disregarded. A trigger tool consisting of 21 triggers will be applied to detect ADEs in older people. The performance of the triggers will be evaluated by calculating the positive and negative predictive value, specificity and sensitivity. The medical records of eligible older people will be analyzed to screen triggers, collect variables and review pharmacotherapy. Expected results: Corroborate evidence on the prospective application of trigger tools through analysis of the usefulness and performance of the screeners. Such findings can support the development and implementation of clinical protocols by the interdisciplinary team with trigger tools for the detection, management and preventability of ADEs.