运用全面触发工具检测老年患者药物不良事件  

Detecting adverse drug events of geriatric patients by the global trigger tool

作　　者：胡巧织 占美[2] 吴斌[2] 徐珽[2] 

机构地区：[1]四川大学华西药学院,成都610041 [2]四川大学华西医院药剂科,成都610041

出　　处：《中国新药杂志》2017年第19期2358-2363,共6页Chinese Journal of New Drugs

摘　　要：目的:探讨全面触发工具(global trigger tool,GTT)用于我国老年患者药物不良事件(adverse drug event,ADE)检测的适用性。方法:随机抽取四川大学华西医院,出院日期在2015年1月1日至2015年12月31日的60岁以上老年患者的病历信息,每月40例共480例。使用GTT推荐的13项触发器并进行筛查后,确定ADE并对其进行严重程度分级。同时,根据病例审查结果对目前的13项触发器进行修正。结果:在审查的480例住院病例中,共发现226例ADE。ADE/1 000患者天为8.31,ADE/100例患者为47.08%,173例患者至少发生过1次ADE的人数占总人数的36.04%。GTT推荐的13项触发器有11项触发器阳性,触发器阳性频次527次,共涉及164例不良事件。另有62例常见ADE无对应触发器支持。根据上述结果,建议可删除2项原有触发器并同时加入5项新的触发器。结论:GTT在检测老年患者药物不良事件方面具有较强的适用性,并为防范用药风险提供参考依据,在我国的医疗机构中有推广价值,但还需要进一步完善。Objective： To examine the applicability of the global trigger tool （GTT）,and to investigate the level,preventability and characteristics of adverse drug event （ADE） in geriatrics.Methods： The study was conducted at West China Hospital of Sichuan University.Forty randomly selected medical records per month for aged patients over sixty were reviewed from 1 January 2015 to 31 December 2015 （totally 480 medical records）.We used 13 trigger in the study,and categorized ADE harm severity.The trigger tools would be amended based on the survey result.Results： A total of 226 ADEs were detected in 480 medical records reviewed （47.08%）.The number of ADEs per 1 000 patient-days was 8.31.ADE occurred at least once in 173 （36.04%） patients.Of all the13 triggers,11 triggers were positive referring to 527 times.The 164 ADEs were found by triggers.However,62 ADEs were not supported by the corresponding triggers.Thus,it was suggested to remove 2 triggers and add other5 triggers to the trigger tool.Conclusion： The frequency and categories of ADE have been detected in geriatrics by GTT.The GTT is a reliable method to detect ADE in Chinese geriatrics,and to help healthcare professionals to prevent ADEs.It is worthy of generalization in Chinese hospitals.

关 键 词：全面触发工具 老年患者 药物不良事件 

分 类 号：R969.3[医药卫生—药理学]