Development and Validation of a Trigger Tool for Identifying Drug-Related Emergency Department Visits

Sung-Hee Hwang, Young-Mi Ah, Kwang-Hee Jun, Jae-Woo Jung, Min-Gyu Kang, Hye-Kyung Park, Eui-Kyung Lee, Hye-Kyung Park, Jee-Eun Chung, Sang-Heon Kim and Ju-Yeun Lee
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Sung-Hee Hwang: College of Pharmacy and Institute of Pharmaceutical Science and Technology, Hanyang University, Ansan 15588, Korea
Young-Mi Ah: College of Pharmacy, Yeungnam University, Gyeongsan 38541, Korea
Kwang-Hee Jun: Institute of Pharmaceutical Sciences, College of Pharmacy and Research, Seoul National University, Seoul 08826, Korea
Jae-Woo Jung: Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul 06974, Korea
Min-Gyu Kang: Department of Internal Medicine, Chungbuk National University Hospital, Cheongju 28644, Korea
Hye-Kyung Park: Department of Internal Medicine, Pusan National University College of Medicine, Busan 50612, Korea
Eui-Kyung Lee: School of Pharmacy, Sungkyunkwan University, Suwon 16419, Korea
Hye-Kyung Park: School of Pharmacy, Sungkyunkwan University, Suwon 16419, Korea
Jee-Eun Chung: College of Pharmacy and Institute of Pharmaceutical Science and Technology, Hanyang University, Ansan 15588, Korea
Sang-Heon Kim: Department of Internal Medicine, Hanyang University College of Medicine, Seoul 04763, Korea
Ju-Yeun Lee: Institute of Pharmaceutical Sciences, College of Pharmacy and Research, Seoul National University, Seoul 08826, Korea

IJERPH, 2021, vol. 18, issue 16, 1-10

Abstract: There are various trigger tools for detecting adverse drug events (ADEs), however, a drug-related emergency department (ED) visit trigger tool (DrEDTT) has not yet been developed. We aimed to develop and validate a DrEDTT with a multi-center cohort. In this cross-sectional study, we developed the DrEDTT consisting of 28 triggers through a comprehensive literature review and three phase expert group discussion. Next, we evaluated the performance of the DrEDTT by applying it to relevant medical records retrieved from four hospitals from January 2016 to June 2016. Two experts performed an in-depth chart review of a 25% of random sample of trigger flagged and unflagged ED visits and a true ADE was determined through causality assessment. Among 66,564 patients who visited the ED for reasons other than traffic accident and trauma during the study period, at least one trigger was found in 21,268 (32.0%) patients. A total of 959 true ADE cases (5.8%) were identified from a randomly selected 25% of ED visit cases. The overall positive predictive value was 14.0% (range: 8.3–66.7%). Sensitivity and specificity of DrEDTT were 77.7% and 70.4%, respectively. In conclusion, this newly developed trigger tool might be helpful to detect ADE-related ED visits.

Keywords: adverse drug events; safety; emergency department; trigger tool; medication safety (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
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