Incidence of Adverse Drug Reaction in Hospitalized Patients in a Nigerian Teaching Hospital Using Global Trigger Tool Methodology

INTRODUCTION:   Adverse drug reactions (ADRs) continue to present the greatest challenges towards the attainment safe healthcare delivery globally. The use of the trigger tools for ADRs signal detection has been shown to be superior to the traditional pharmacovigilance system that rely on the direct observation and unfocused chart review by healthcare professionals. The main objectives of this study was to determine the incidence and severity of adverse drug reactions, (ADRs) among hospitalized patients using global trigger tool methodology, (GTTM). We also assessed the knowledge and attitude of healthcare professionals about the use of the (GTTM) for signal detection of ADRs in the Nnamdi Azikiwe University Teaching Hospital, Nnewi.

METHODS: A descriptive cross-sectional study was conducted using retrospective medication chart review of hospitalized patients and questionnaire survey methodology of health care professionals employed in the teaching hospital. The chart review procedure was adapted from the method described in the global trigger tool methodology of the Institute of Health Improvements, (IHI).

RESULTS: A total of 120 patients’ charts randomly selected and reviewed; reflecting a total of 2173 patient-days of which 558 were for pediatrics. Over 473 triggers were identified of which 175 were confirmed to be ADRs. The vital incidence measures calculated were: 145.8 ADRs per 100 admissions and 80.5 ADRs per 1000 patient-days. A total of 97 patients had at least one ADR during their hospitalization and the per cent of admissions with an adverse event was 80.8%.

Majority (94.4%) of the surveyed health care professionals agreed that ADRs should be identified and reported whenever they are encountered in patients. However, almost all of them (97.5 %) showed they did not know about the GTTM for detecting and reporting of ADRs.

CONCLUSIONS: There was high incidence of ADRs among the hospitalized patients included in this survey. The healthcare professionals who took part in the questionnaire survey showed low level of awareness about the trigger tool methodology and its use in the detection and reporting of ADRs. This has implication for patients’ safety. Further research is thus required to explore the strategies to create more awareness among healthcare professionals towards effective use of the global trigger tool methodology as part of their routine care of patients in order to promote patients safety.