Trigger tools to identify adverse drug events in hospitalised children: A systematic review

Area of Science:

• Pediatric pharmacology
• Patient safety
• Health informatics

Background:

• Adverse drug events (ADEs) are a significant concern in pediatric healthcare.
• Effective detection methods are crucial for improving patient safety in children.
• Current trigger tools for ADE detection in pediatric populations require thorough evaluation.

Purpose of the Study:

• To comprehensively identify and evaluate trigger tools for detecting ADEs in hospitalized children.
• To assess the performance of these triggers using positive predictive value (PPV).
• To explore the utility of triggers in real-time ADE detection systems for pediatric care.

Main Methods:

• A systematic literature search of PubMed was conducted up to December 2021.
• Studies utilizing triggers for ADE identification in pediatric inpatients were included.
• Triggers related exclusively to care procedures were excluded; only ADE-specific triggers were analyzed.

Main Results:

• A total of 271 unique triggers were identified across 30 studies, with 179 linked to drug-induced harms.
• Nineteen triggers (11%) demonstrated a mean PPV between 50% and 100%, including five with 100% PPV.
• Identified triggers varied in their applicability for ADE prevention, verification, and reporting.

Conclusions:

• Individual trigger performance requires further rigorous investigation.
• Computerized triggers and real-time detection systems for ADEs in children represent a critical but emerging area.
• The frequent off-label use of medications in children underscores the need for enhanced ADE detection strategies.