ArticleBMJ quality & safety2012
Signal and noise: applying a laboratory trigger tool to identify adverse drug events among primary care patients.
Article in BMJ quality & safety, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
23 citing papers in PubMed, 2 syntheses or guidelines pooled it, 44 citations in OpenAlex.
- Prevalence of adverse drug reactions in the primary care setting: A systematic review and meta-analysis.PloS one · 2021Pooled it
- Using Electronic Health Records to Identify Adverse Drug Events in Ambulatory Care: A Systematic Review.Applied clinical informatics · 2019Pooled it
- Nurse-Led Medicines' Monitoring for Patients with Dementia in Care Homes: A Pragmatic Cohort Stepped Wedge Cluster Randomised Trial.PloS one · 2015Trial
- Trial
- Post-pandemic patient safety: have the characteristics of incidents with harm changed? Comparative observational study in primary care via review of medical records with a trigger tool.BMC primary care · 2024Observational
- Nobody ever questions-Polypharmacy in care homes: A mixed methods evaluation of a multidisciplinary medicines optimisation initiative.PloS one · 2021Article
- Looking for the "Little Things": A Multi-Disciplinary Approach to Medicines Monitoring for Older People Using the ADRe Resource.Geriatrics (Basel, Switzerland) · 2020Article
- Global Trigger Tool: Proficient Adverse Drug Reaction Autodetection Method in Critical Care Patient Units.Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine · 2020Article
- Development of a trigger tool for the detection of adverse drug events in Chinese geriatric inpatients using the Delphi method.International journal of clinical pharmacy · 2019Article
- Article
- Application of the emergency medical services trigger tool to measure adverse events in prehospital emergency care: a time series analysis.BMC emergency medicine · 2018Article
- Development of a standardized chart review method to identify drug-related hospital admissions in older people.British journal of clinical pharmacology · 2018Article
- Article
- Adverse Drug Reactions, Power, Harm Reduction, Regulation and the ADRe Profiles.Pharmacy (Basel, Switzerland) · 2018Article
- Performance of trigger tools in identifying adverse drug events in emergency department patients: a validation study.British journal of clinical pharmacology · 2016Article
- CareTrack Kids-part 3. Adverse events in children's healthcare in Australia: study protocol for a retrospective medical record review.BMJ open · 2015Article
- Application of a trigger tool in near real time to inform quality improvement activities: a prospective study in a general medicine ward.BMJ quality & safety · 2015Article
- Assessing the potential adoption and usefulness of concurrent, action-oriented, electronic adverse drug event triggers designed for the outpatient setting.EGEMS (Washington, DC) · 2015Article
- Validation of triggers and development of a pediatric trigger tool to identify adverse events.BMC health services research · 2014Review
- Can an electronic health record system be used for preconception health optimization?Maternal and child health journal · 2014Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundThe extent of outpatient adverse drug events (ADEs) remains unclear. Trigger tools are used as a screening method to identify care episodes that may be ADEs, but their value in a population with high chronic-illness burden remains unclear.
methodsThe authors used six abnormal laboratory triggers for detecting ADEs among adults in outpatient care. Eligible patients were included if they were >18 years, sought primary or urgent care between November 2008 and November 2009 and were prescribed at least one medication. The authors then used the clinical / administrative database to identity patients with these triggers. Two physicians conducted in-depth chart review of any medical records with identified triggers.
resultsThe authors reviewed 1342 triggers representing 622 unique episodes among 516 patients. The trigger tool identified 91 (15%) ADEs. Of the 91 ADEs included in the analysis, 49 (54%) occurred during medication monitoring, 41 (45%) during patient self-administration, and one could not be determined. 96% of abnormal international normalised ratio triggers were ADEs, followed by 12% of abnormal blood urea nitrogen triggers, 9% of abnormal alanine aminotransferase triggers, 8% of abnormal serum creatinine triggers and 3% of aspartate aminotransferase triggers.
conclusionsThe findings imply that other tools such as text triggers or more complex automated screening rules, which combine data hierarchically are needed to effectively screen for ADEs in chronically ill adults seen in primary care.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.