Avaliação da metodologia Trigger Tool para detecção de reações adversas em um hospital sentinela no Brasil

Pharmacovigilance plays a critical role in identifying adverse drug reactions (ADRs). However, barriers to implementing processes and services that incorporate pharmacovigilance in healthcare settings have hindered efforts to enhance patient safety in hospitals. This study aimed to evaluate the use of the Trigger Tool, developed by the Institute for Healthcare Improvement, for the active detection of ADRs and to compare its performance with voluntary ADR reporting in a sentinel hospital in Brazil. This descriptive study analyzed data recorded between 2020 and 2022. Triggers were selected based on the Global Trigger Tool’s standard list, focusing on identifying potential ADRs. The causal relationship of each ADR was assessed using the Naranjo Algorithm and the WHO-Uppsala Monitoring Centre criteria. The active search identified 97 potential ADRs involving 91 patients, compared to just two ADRs reported through voluntary notifications. Causality assessments showed a higher prevalence of classifications deemed “possible” by both algorithms. The most common harm categorization was “temporary harm.” The methodology identified 465 trigger events, with antidote-related triggers (e.g., Naloxone, Flumazenil, Protamine) demonstrating the highest detection rates. These findings highlight that implementing an active ADR detection methodology in hospitals is a feasible and effective approach to improving clinical planning and enhancing patient safety.