Effectiveness of the Trigger Tool Approach in Identifying Adverse Drug Reactions: A Study at a Tertiary Care Teaching Hospital

Background: Patients in tertiary care hospitals are often affected by significant ADRs that increase illness and the duration of their hospital stays. Often such systems neglect to detect many ADRs for two reasons: people do not report them and their observers have biases. By using Trigger Tool, designed by the IHI, clinicians can proactively recognize ADRs with the help of several clinical, laboratory and prescription-based indicators. Aim: To evaluate how well the Trigger Tool works in finding adverse drug reactions, relative to the way adverse events are reported by health personnel. Methods: The study was designed as prospective, cross-sectional research at Department of Pharmacology, ESIC Medical College and Hospital, Bihta, Patna, Bihar, India for one year. Using a modified Trigger Tool checklist, we screened 200 inpatients who had been admitted to the hospital to find incidents to review. Causality of the identified triggers was assessed using the WHO-UMC causality scale, the Naranjo algorithm, Hartwig and Siegel’s severity scale and Scheumock and Thornton’s preventability assessment. ADRs reported spontaneously by people using the drug were also recorded to check for similar results. Results: 200 patients examined, 67 had signs that suggested an ADR and a detailed review confirmed 51 ADRs. Among all ADRs confirmed, more than half were considered possible (54.9%) and the severity was mostly listed as moderate (64.7%). 43.1% of the ADRs in the study were tagged as preventable. Meanwhile, the spontaneous reporting system captured 21 reports of ADRs during those six months and had both fewer moderate-to-severe cases and lower preventability rates (19.0%). Conclusion: The Trigger Tool method was far better than spontaneous reporting at finding both the number and clinical importance of ADRs. It is a useful tool for improving patient safety and improving pharmacovigilance practices in healthcare settings with limited resources since it can find preventable and moderate-to-severe ADRs