Reduction in Anticoagulation-Related Adverse Drug Events Using a Trigger-Based Methodology

Lederer, Jim; Best, Diana

doi:10.1016/s1553-7250(05)31040-3

Cited by 7 publications

(15 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Therefore, 15 studies with a total of 278,212 patients and 126,197 incidents of positive triggers were included in this review. 17,20,31,[33][34][35][36][37][38][39][40][41][42][43][44][45] Of the 15 included studies, 9 were conducted in the United States, 3 in Scotland, and 1 each in Brazil, France, and Australia (Table 2). Eight studies were published since 2010 and 2 were published before 2000.…”

Section: Resultsmentioning

confidence: 99%

“…20,31,34,35,37 The most commonly used method to identify pAEs was chart review. 20,31,[33][34][35][36][37][38][39][40][41][42][43][44] Four studies used physicians only as reviewers 35,37,38,40 , 3 used a combination of physicians and pharmacists. 33,36,41 1 used nurses 34 , 1 used pharmacists 44 , and 1 used a combination of physicians and nurses 20 , 5 studies used more than 1 reviewer and all these used at least 2 independent reviewers.…”

Section: Adverse Eventsmentioning

confidence: 99%

“…33,36,41 1 used nurses 34 , 1 used pharmacists 44 , and 1 used a combination of physicians and nurses 20 , 5 studies used more than 1 reviewer and all these used at least 2 independent reviewers. 20,33,[37][38][39] Interrater reliability of chart review was assessed in 4 studies 33,37,40,44 and ranged from a Cohen's kappa of 0.33 37 to 0.89. 44 Bigby et al 37 showed an intrarater Trigger 9: complaint letter Look to see if the complaint related to an event (i.e., request for the waiver of co-payment, payment or concern about quality of care).…”

Section: Adverse Eventsmentioning

confidence: 99%

“…The most IHI triggers used in a study was 5. Eight studies 17,20,33,36,39,40,42,44 paired triggers from the IHI tool with other triggers, such as free text searches of charts 33,39,40 , new allergy or "high-priority" codes 20,35,40 , ICD-9 codes 39,40 , antidote administration 33,36 , symptom review 44 , and incident reporting. 33 Triggers that were studied individually included lab abnormality 38 -40,44 , polypharmacy 43,45 , and hospital admission.…”

Section: Triggersmentioning

confidence: 99%

“…31,37,42 The definition of polypharmacy provided by the IHI tool is Ͼ5 medications; however, studies in this review used numbers from 4 to 12. 43,45 Lab abnormalities evaluated across all studies included international normalized ratio (INR), 33,34,36,38 -41 creatinine 17,33-36,38 -41 , hemoglobin 17,[33][34][35][36]40 , potassium, 33,36,39,40 aminotransferase enzymes 33,35,37 , eosinophilia 33,35,39 , platelet count 33,36,38 , toxic drug levels 33,36,40 , bilirubin 36,40 , blood urea nitrogen 36,38 , hemoglobin A1c 33,36 , thyroid-stimulating hormone (TSH) 36,38 , positive C. difficile 33,36 , and white blood cell count. 40 Brenner et al 37 found no patients with an undetectable TSH while on levothyroxine and Singh et al 17 found that toxic drug levels, hemoglobin, platelet count, eosinophilia, potassium, bilirubin, alkaline phosphatase, hemoglobin A1c, and C. difficile had incredibly low PPVs.…”

Section: Triggersmentioning

confidence: 99%

See 4 more Smart Citations

The Accuracy of Trigger Tools to Detect Preventable Adverse Events in Primary Care: A Systematic Review

et al. 2018

View full text Add to dashboard Cite

Purpose: To understand the ability of trigger tools to detect preventable adverse events (pAEs) in the primary care outpatient setting using the Institute for Healthcare Improvement's (IHI) Outpatient Adverse Event Trigger Tool (IHI Tool).Methods: The OVID MEDLINE and OVID MEDLINE In-process and non-Indexed citations databases were queried using controlled vocabulary and Medical Subject Headings related to the concepts "primary care" and "adverse events." Included articles were conducted in the outpatient setting, used at least 1 of the triggers identified in the IHI Tool, and identified pAEs of any type. Articles were selected for inclusion based first on assessment of titles then abstracts by 2 trained reviewers independently, followed by full text review by 2 authors.Results: Our search identified 6435 unique articles, and we included 15 in our review. The most common studied trigger was laboratory abnormalities. The most common pAEs were medication errors followed by unplanned hospitalizations. The effectiveness of triggers in identifying AEs varied widely.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Adverse Eventsmentioning

confidence: 99%

Section: Adverse Eventsmentioning

confidence: 99%

Section: Triggersmentioning

confidence: 99%

Section: Triggersmentioning

confidence: 99%

See 3 more Smart Citations

The Accuracy of Trigger Tools to Detect Preventable Adverse Events in Primary Care: A Systematic Review

et al. 2018

View full text Add to dashboard Cite

show abstract

Predictors of warfarin‐associated adverse events in hospitalized patients: Opportunities to prevent patient harm

Metersky

Eldridge

Wang³

et al. 2015

Journal of Hospital Medicine

View full text Add to dashboard Cite

BACKGROUND The optimum international normalized ratio (INR) monitoring frequency for hospitalized patients receiving warfarin is unknown. OBJECTIVE Assess relationship between daily versus less frequent INR monitoring and overanticoagulation and warfarin‐related adverse events. DESIGN Retrospective cohort study using Medicare Patient Safety Monitoring System data. SETTING Randomly selected acute care hospitals across the United States. PATIENTS Patients hospitalized from 2009 to 2013 for pneumonia, acute cardiac disease, or surgery who received warfarin. INTERVENTIONS None. MEASUREMENTS (1) Association between frequency of INR monitoring and an INR ≥6.0 or warfarin‐related adverse event. (2) Association between the rate of change of the INR and a subsequent INR ≥5.0 and ≥6.0. RESULTS Among 8529 patients who received warfarin for ≥3 days, for 1549 (18.2%) the INR was not measured on 2 or more days. These patients had higher propensity‐adjusted odds ratios (ORs) of having a warfarin‐associated adverse event (OR: 1.48, 95% confidence interval [CI]: 1.02‐2.17) for cardiac patients and surgical patients (OR: 1.73, 95% CI: 1.20‐2.48), with no significant association for pneumonia patients. Cardiac and pneumonia patients with 1 day or more without an INR measurement had higher propensity‐adjusted ORs of having an INR ≥6.0 (OR: 1.61, 95% CI: 1.07‐2.41 and OR: 1.92, 95% CI: 1.36‐2.71, respectively). A 1‐day increase in the INR of ≥0.9 occurred in 621 patients (12.5%) and predicted a subsequent INR of ≥6.0 (positive likelihood ratio of 4.2). CONCLUSION Daily INR measurement and recognition of a rapidly rising INR might decrease the frequency of warfarin‐associated adverse events in hospitalized patients. Journal of Hospital Medicine 2016;11:276–282. © 2015 Society of Hospital Medicine

show abstract

Methodological gaps in the assessment of risk minimization interventions: a systematic review

Gridchyna

Cloutier

Nkeng

et al. 2014

Pharmacoepidemiology and Drug

View full text Add to dashboard Cite

show abstract

Reduction in Anticoagulation-Related Adverse Drug Events Using a Trigger-Based Methodology

Cited by 7 publications

References 0 publications

The Accuracy of Trigger Tools to Detect Preventable Adverse Events in Primary Care: A Systematic Review

The Accuracy of Trigger Tools to Detect Preventable Adverse Events in Primary Care: A Systematic Review

Predictors of warfarin‐associated adverse events in hospitalized patients: Opportunities to prevent patient harm

Methodological gaps in the assessment of risk minimization interventions: a systematic review

Contact Info

Product

Resources

About