Performance of a trigger tool for detecting drug-related hospital admissions in older people: analysis from the OPERAM trial.

Zerah, Lorène; Henrard, Séverine; Thevelin, Stefanie; Feller, Martin; Meyer-Massetti, Carla; Knol, Wilma; Wilting, Ingeborg; O'Mahony, Denis; Crowley, Erin; Dalleur, Olivia; Spinewine, Anne (2022). Performance of a trigger tool for detecting drug-related hospital admissions in older people: analysis from the OPERAM trial. Age and ageing, 51(1), pp. 1-13. Oxford University Press 10.1093/ageing/afab196

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BACKGROUND

identifying drug-related hospital admissions (DRAs) in older people is difficult. A standardised chart review procedure has recently been developed. It includes an adjudication team (physician and pharmacist) screening using 26 triggers and then performing causality assessment to determine whether an adverse drug event (ADE) occurred (secondary to an adverse drug reaction, overuse, misuse or underuse) and whether the ADE contributed to hospital admission (DRA).

OBJECTIVE

to assess the performance of those triggers in detecting DRA.

DESIGN

retrospective study using data from the OPERAM (OPtimising thERapy to prevent Avoidable hospital admissions in Multimorbid older people) trial.

SETTINGS

four European medical centres.

SUBJECTS

multimorbid (≥ 3 chronic medical conditions) older (≥ 70 years) inpatients with polypharmacy (≥ 5 chronic medications) were enrolled in the OPERAM trial (N = 2,008) and followed for 12 months. We included patients with ≥1 adjudicated hospitalisation during the follow-up.

METHODS

the positive predictive value (PPV; number of DRAs identified by trigger/number of triggers) was calculated for each trigger and for the tool as a whole.

RESULTS

of 1,235 hospitalisations adjudicated for 832 patients, 716 (58%) had at least one trigger; an ADE was identified in 673 (54%) and 518 (42%) were adjudicated as DRAs. The overall PPV of the trigger tool for detecting DRAs was 0.66 [0.62-0.69].

CONCLUSIONS

this tool performs well for identifying DRAs in older people. Based on our results, a revised version of the tool was proposed but will require external validation before it can be incorporated into research and clinical practice.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of General Internal Medicine (DAIM) > Clinic of General Internal Medicine
04 Faculty of Medicine > Medical Education > Institute of General Practice and Primary Care (BIHAM)

UniBE Contributor:

Feller, Martin, Meyer-Massetti, Carla Verena

Subjects:

600 Technology > 610 Medicine & health
300 Social sciences, sociology & anthropology > 360 Social problems & social services

ISSN:

0002-0729

Publisher:

Oxford University Press

Funders:

[201] Staatssekretariat für Bildung, Forschung und Innovation (SBFI) = Swiss State Secretariat for Education, Research and Innovation (SERI)

Language:

English

Submitter:

Andrea Flükiger-Flückiger

Date Deposited:

23 Nov 2021 11:46

Last Modified:

05 Dec 2022 15:55

Publisher DOI:

10.1093/ageing/afab196

Related URLs:

PubMed ID:

34794171

Uncontrolled Keywords:

drug-related side effects and adverse reaction hospital admission older people trigger tool

BORIS DOI:

10.48350/161433

URI:

https://boris.unibe.ch/id/eprint/161433

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