TRIGGER TOOLS AND ADVERSE DRUG EVENTS AT A LARGE GENERAL HOSPITAL IN SÃO PAULO/SP, BRAZIL

OBJECTIVE: The aim of this study was to identify the main adverse drug events (ADEs), and its severity in patients of a large public hospital in São Paulo city using trigger tools and to evaluate its performance. METHODS: This is a prospective study with adults hospitalized in the units of Surgical Center, Medical Clinic, Intensive Care Unit, Adult Emergency Room and Obstetrics, during a period of two months (May to June 2021). Clinical records were reviewed using eleven different trigger tools selected from the Global Trigger Tools of the Institute of Healthcare and adapted to the Hospital reality. Only trigger medications were used. The active search was performed using Hospital’s computerized system and when the prescription of a trigger drug was identified, the pharmacist analyzed the patient’s medical record. RESULTS: There were identified 183 patients with trigger medication prescription. Of these 14,7% presented adverse drug event and were admitted at Medical Clinic (48%). The ADEs identified were pruritus/ skin rash, coumarin poisoning/bleeding, anaphylaxis, excessive sedation, and headache. Considering the severity, 93,6% were moderate and 3,7% severe. The drugs with highest incidence of ADEs were morphine and warfarin. The best performing trigger tools were protamine and flumazenil, and the lowest performing were hydrocortisone and promethazine. CONCLUSION: Trigger tools can be used to identify adverse drug reactions. Its use in hospitals improve patients’ medication safety.