ArticleEuropean geriatric medicine2022
Performance of a trigger tool for detecting adverse drug reactions in patients with polypharmacy acutely admitted to the geriatric ward.
Article in European geriatric medicine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.
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Who cites it
7 citing papers in PubMed, 1 synthesis or guideline pooled it, 10 citations in OpenAlex.
- Hospital admissions due to adverse drug reactions and adverse drug events in older adults: a systematic review.Age and ageing · 2025Pooled it
- Implementing a clinical pharmacy intervention for older adult inpatients with chronic non-cancer pain: a feasibility study.International journal of clinical pharmacy · 2026Article
- Article
- Drug-Event Pairs as Indicators for the Detection of Adverse Drug Reactions during Hospitalization in Routinely Collected Electronic Data Sources.Clinical pharmacology and therapeutics · 2025Article
- Comparing the performance of multiple trigger tools in identifying medication-related hospital readmissions.Journal of the American Geriatrics Society · 2025Article
- Application and evaluation of the global trigger tool approach to adverse drug event monitoring in the high-risk elderly inpatients with multiple chronic diseases.Frontiers in pharmacology · 2025Article
- Adverse Drug Reactions Related with Antibiotic Medicines in Malawi: A Retrospective Analysis of Prevalence and Associated Factors.Drug, healthcare and patient safety · 2024Article
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Authors and funding
7 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeAdverse drug reactions (ADRs) account for 10% of acute hospital admissions in older people, often under-recognised by physicians. The Dutch geriatric guideline recommends screening all acutely admitted older patients with polypharmacy with an ADR trigger tool comprising ten triggers and associated drugs frequently causing ADRs. This study investigated the performance of this tool and the recognition by usual care of ADRs detected with the tool.
methodsA cross-sectional study was performed in patients ≥ 70 years with polypharmacy acutely admitted to the geriatric ward of the University Medical Centre Utrecht. Electronic health records (EHRs) were screened for trigger-drug combinations listed in the ADR trigger tool. Two independent appraisers assessed causal probability with the WHO-UMC algorithm and screened EHRs for recognition of ADRs by attending physicians. Performance of the tool was defined as the positive predictive value (PPV) for ADRs with a possible, probable or certain causal relation.
resultsIn total, 941 trigger-drug combinations were present in 73% (n = 253/345) of the patients. The triggers fall, delirium, renal insufficiency and hyponatraemia covered 86% (n = 810/941) of all trigger-drug combinations. The overall PPV was 41.8% (n = 393/941), but the PPV for individual triggers was highly variable ranging from 0 to 100%. Usual care recognised the majority of ADRs (83.5%), increasing to 97.1% when restricted to possible and certain ADRs.
conclusionThe ADR trigger tool has predictive value; however, its implementation is unlikely to improve the detection of unrecognised ADRs in older patients acutely admitted to our geriatric ward. Future research is needed to investigate the tool's clinical value when applied to older patients acutely admitted to non-geriatric wards.
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