Evaluation of Global trigger tool as a medication safety tool for adverse drug event detection-a cross-sectional study in a tertiary hospital

The objective of this study is to describe and analyze adverse drug events (ADE) identified using the Global trigger tool (GTT) in a Finnish tertiary hospital during a 5-year period and also to evaluate whether the medication module of the GTT is a useful tool for ADE detection and management or if modification of the medication module is needed. A cross-sectional study of retrospective record review in a 450-bed tertiary hospital in Finland. Ten randomly selected patients from electronic medical records were reviewed bimonthly from 2017 to 2021. The GTT team reviewed a total of 834 records with modified GTT method, which includes the evaluation of possible polypharmacy, National Early Warning Score (NEWS), highest nursing intensity raw score (NI), and pain triggers. The data set contained 366 records with triggers in medication module and 601 records with the polypharmacy trigger that were analyzed in this study. With the GTT, a total of 53 ADEs were detected in the 834 medical records, which corresponds to 13 ADEs/1000 patient-days and 6% of the patients. Altogether, 44% of the patients had at least one trigger found with the GTT medication module. As the number of medication module triggers increased per patient, it was more likely that the patient had also experienced an ADE. The number of triggers found with the GTT medication module in patients' records seems to correlate with the risk of ADEs. Modification of the GTT could provide even more reliable data for ADE prevention.