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Identification of adverse drug event rate in academic medical centers in Israel and Validation of a tool for continuous monitoring
Researchers: Amitai Ziv1, Eyal Zimlichman1, Ronen Loebstien1, Ortal Sharlin1, Ohud Hochman2, Orna Tal3
- Sheba Medical Center
- Helel Yafe Medical Center
- Asaf Hrofe Medical Center
Background: Medications represent a major cause of harm in hospitalized patients. Studies made in the US found that they are the cause to about 20% of all hospital harms. In 2004 a tool (Trigger Tool for Measuring ADEs) was developed in the US in order to measure adverse drug events in a retrospective way. This tool has been used routinely in the US and in some other countries but has not been tried or adapted for Israel.
Objectives: 1. Validation and adaptation of the IHI trigger tool for ADEs to Israeli general hospitals.
2. Identification of adverse drug event rate in public medical centers in Israel.
2. Identification of adverse drug event rate in public medical centers in Israel.
Method: This will be Retrospective Descriptive Analysis study conducted at four academic teaching general public hospital in Israel.
The IHIs' “trigger tool” will be used to identify and characterize ADEs based on manual randomized chart review for 240 admissions per period at each site (total of 960 chart reviews).
The IHIs' “trigger tool” will be used to identify and characterize ADEs based on manual randomized chart review for 240 admissions per period at each site (total of 960 chart reviews).
Findings: A total of 421 triggers were found in 279 records and total of 75 ADEs were found in 72 records.
The overall PPV was 17.81%. The PPV in each site ranged from 11.83% to 24.21%. The NPV was 99.99%. 1.81 ADEs were found per 1000 doses, 1.54 ADEs per 100 patient days and 7.81 ADEs per 100 patients. 50 ADEs were in the harm level of E, 23 in the harm level of F and 2 in the harm level of I.
The overall PPV was 17.81%. The PPV in each site ranged from 11.83% to 24.21%. The NPV was 99.99%. 1.81 ADEs were found per 1000 doses, 1.54 ADEs per 100 patient days and 7.81 ADEs per 100 patients. 50 ADEs were in the harm level of E, 23 in the harm level of F and 2 in the harm level of I.
Conclusions: The PPV of 17.81% found in the current research was relatively high when compared to PPVs found in other researches made in other countries ranged from 4.17% to 21.50%.
Recommendations: The relatively high PPV found in the current research points that the tool can be used efficiently in Israel, but it can be improved by doing some adaptation to the triggers.
Research number: R/157/2014
Research end date: 04/2017