Validating a Trigger Tool for Detecting Adverse Drug Events in Elderly Patients With Multimorbidity (TRIGGER-CHRON)

Area of Science:

• Geriatric Medicine
• Clinical Pharmacology
• Patient Safety

Background:

• Elderly patients with multimorbidity are at high risk for adverse drug events (ADEs).
• Effective tools are needed to detect ADEs in this vulnerable population within clinical practice.
• Existing ADE detection methods may lack efficiency or specificity.

Purpose of the Study:

• To evaluate an initial list for detecting ADEs in elderly patients with multimorbidity.
• To shorten and validate this list for practical clinical use.
• To assess the incidence and characteristics of ADEs in this patient group.

Main Methods:

• An observational study involving retrospective chart review across 12 Spanish hospitals.
• Utilized a list of 51 expert-selected triggers to identify potential ADEs.
• Calculated the positive predictive value (PPV) of each trigger to refine the list.

Main Results:

• Reviewed 720 charts, identifying 215 ADEs in 178 patients (24.7%).
• 13% of ADEs were serious, and 55.3% were preventable, often due to monitoring or prescribing errors.
• A refined list of 32 triggers (TRIGGER-CHRON) achieved a 22.1% PPV, capturing 98.9% of ADEs.

Conclusions:

• The validated TRIGGER-CHRON tool is an efficient method for detecting ADEs in elderly patients with multimorbidity.
• This shorter list effectively identifies ADEs in approximately one-fourth of hospitalized patients.
• The tool aids in understanding ADE incidence and characteristics in this population.