ArticleBritish journal of clinical pharmacology2026
Supratherapeutic drug concentration triggers: A novel data-driven approach to assess their value for medication safety surveillance in intensive care.
Article in British journal of clinical pharmacology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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Who cites it
1 citing paper in PubMed.
- Supratherapeutic drug concentration triggers: A novel data-driven approach to assess their value for medication safety surveillance in intensive care.British journal of clinical pharmacology · 2026Article
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6 authors.
Funding
Abstract
aimsElectronic triggers (e-triggers) are used as screening signals to detect potential adverse drug events (ADEs) and offer an effective system level approach for medication safety surveillance. Their clinical utility is typically evaluated through time-consuming manual chart review by experts, limiting implementation. Estimating associations between e-triggers and relevant ICU patient outcomes may provide a rapid, data-driven alternative. In this study, electronic supratherapeutic drug concentration triggers (eSDCT) were used as a use case.
methodsPseudonymized Electronic Health Record (EHR) data from adults admitted to 14 Dutch ICUs (2010-2020) were analysed. Patients with ≥1 therapeutic drug monitoring measurements were included. eSDCTs were selected based on literature, data availability and expert input. Associations with ICU Length of Stay (LOS), ICU mortality and hospital mortality were assessed using adjusted linear and logistic mixed-effects models.
resultsAmong 6006 ICU admissions, 49.5% (n = 2973) had ≥1 of the five selected group-level eSDCTs. Exposed admissions showed higher hospital mortality (38.2% vs. 27.9%), ICU mortality (30.6% vs. 20.3%) and longer ICU LOS (median 13.8 [IQR 5.6-28.1] vs. 7.5 [3.2-15.7] days) compared with unexposed admissions. After adjustment, antibiotic and immunosuppressive eSDCTs remained associated with increased ICU mortality (OR 1.47 [1.26-1.70] and 2.86 [1.56-5.24]), hospital mortality (OR 1.46 [1.27-1.68] and 1.81 [1.07-3.10]) and prolonged ICU LOS (expB 1.82 [1.71-1.94] and 2.99 [2.46-3.62]).
conclusionOur data-driven approach shows that antibiotic and immunosuppressive eSDCTs are associated with worse ICU patient outcomes, supporting their implementation for ICU-level medication safety surveillance.
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