Skip to main content

Advertisement

Log in

Development of a ‘ready-to-use’ tool that includes preventability, for the assessment of adverse drug events in oncology

  • Research Article
  • Published:
International Journal of Clinical Pharmacy Aims and scope Submit manuscript

Abstract

Background Adverse drug events (ADEs) occur frequently in oncology and justify continuous assessment and monitoring. There are several methods for detecting them, but the trigger tool method seems the most appropriate. Although a generic tool exists, its use for ADEs in oncology has not been convincing. The development of a focused version is therefore necessary. Objective To provide an oncology-focused trigger tool that evaluates the prevalence, harm, and preventability in a standardised method for pragmatic use in ADE surveillance. Setting Hospitals with cancer care in France. Method The tool has been constructed in two steps: (1) constitution of an oncology-centred list of ADEs; 30 pharmacists/practitioners in cancer care from nine hospitals selected a list of ADEs using a method of agreement adapted from the RAND/UCLA Appropriateness Method; and (2) construction of three standardised dimensions for the characterisation of each ADE (including causality, severity, and preventability). Main outcome measure The main outcome measure was validation of the tool, including preventability criteria. Results The tool is composed of a final list of 15 ADEs. For each ADE, a ‘reviewer form’ has been designed and validated by the panel. It comprises (1) the trigger(s), (2) flowcharts to guide the reviewer, (3) criteria for grading harm, and (4) a standardised assessment of preventability with 6–14 closed sentences for each ADE in terms of therapeutic management and/or prevention of side-effects. Conclusion A complete ‘ready-to-use’ tool for ADE monitoring in oncology has been developed that allows the assessment of three standardised dimensions.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1

Similar content being viewed by others

References

  1. World Health Organization. WHO draft guidelines for adverse event reporting and learning systems: from information to action [Internet]. Geneva. 2005. http://apps.who.int/iris/handle/10665/69797.

  2. Brennan TA, Leape LL, Laird NM, Hebert L, Localio AR, Lawthers AG, et al. Incidence of adverse events and negligence in hospitalized patients. Results of the Harvard Medical Practice Study I. N Engl J Med. 1991;324:370–6.

    Article  CAS  PubMed  Google Scholar 

  3. Bates DW, Leape LL, Carruthers SG. Melmon and Morrelli’s clinical pharmacology: basic principles in therapeutics. New York: McGraw-Hill; 2000.

    Google Scholar 

  4. Lipczak H, Neckelmann K, Steding-Jessen M, Jakobsen E, Knudsen JL. Uncertain added value of Global Trigger Tool for monitoring of patient safety in cancer care. Dan Med Bull. 2011;58:A4337.

    PubMed  Google Scholar 

  5. Lipczak H, Knudsen JL, Nissen A. Safety hazards in cancer care: findings using three different methods. BMJ Qual Saf. 2011;20:1052–6.

    Article  PubMed  Google Scholar 

  6. Nazer LH, Hawari F, Al-Najjar T. Adverse drug events in critically ill patients with cancer: incidence, characteristics, and outcomes. J Pharm Pract. 2014;27:208–13.

    Article  PubMed  Google Scholar 

  7. Jha AK, Kuperman GJ, Teich JM, Leape LL, Shea B, Rittenberg E, et al. Identifying adverse drug events: development of a computer-based monitor and comparison with chart review and stimulated voluntary report. J Am Med Inform Assoc. 1998;5:305–14.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  8. Kilbridge PM, Campbell UC, Cozart HB, Mojarrad MG. Automated surveillance for adverse drug events at a community hospital and an academic medical center. J Am Med Inform Assoc. 2006;13:372–7.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Wong BM, Dyal S, Etchells EE, Knowles S, Gerard L, Diamantouros A, et al. Application of a trigger tool in near real time to inform quality improvement activities: a prospective study in a general medicine ward. BMJ Qual Saf. 2015;24:272–81.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Chassin MR, Galvin RW. The urgent need to improve health care quality. Institute of Medicine National Roundtable on Health Care Quality. JAMA. 1998;280:1000–5.

    Article  CAS  PubMed  Google Scholar 

  11. Michel P, Quenon JL, de Sarasqueta AM, Scemama O. Comparison of three methods for estimating rates of adverse events and rates of preventable adverse events in acute care hospitals. BMJ. 2004;328:199.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Griffin FA, Resar RK. IHI Global Trigger Tool for measuring adverse events. 2nd ed. Cambridge: Institute for Healthcare Improvement; 2009.

    Google Scholar 

  13. Classen DC, Resar RK, Griffin FA, Federico F, Frankel T, Kimmel N, et al. ‘Global trigger tool’ shows that adverse events in hospitals may be ten times greater than previously measured. Health Aff (Millwood). 2011;30:581–9.

    Article  Google Scholar 

  14. Härkänen M, Kervinen M, Ahonen J, Voutilainen A, Turunen H, Vehviläinen-Julkunen K. Patient-specific risk factors of adverse drug events in adult inpatients – evidence detected using the Global Trigger Tool method. J Clin Nurs. 2015;24:582–91.

    Article  PubMed  Google Scholar 

  15. Sharek PJ. The Emergence of the Trigger Tool as the Premier Measurement Strategy for Patient Safety. AHRQ WebM&M. 2012;2012:1–5.

    Google Scholar 

  16. Takata GS, Mason W, Taketomo C, Logsdon T, Sharek PJ. Development, testing, and findings of a pediatric-focused trigger tool to identify medication-related harm in US children’s hospitals. Pediatrics. 2008;121:e927–35.

    Article  PubMed  Google Scholar 

  17. Sharek PJ, Horbar JD, Mason W, Bisarya H, Thurm CW, Suresh G, et al. Adverse events in the neonatal intensive care unit: development, testing, and findings of an NICU-focused trigger tool to identify harm in North American NICUs. Pediatrics. 2006;118:1332–40.

    Article  PubMed  Google Scholar 

  18. Mull HJ, Rosen AK, Shimada SL, Rivard PE, Nordberg B, Long B, et al. Assessing the potential adoption and usefulness of concurrent, action-oriented, electronic adverse drug event triggers designed for the outpatient setting. EGEMS (Washington, DC). 2015;3:1116.

    Google Scholar 

  19. Rosen AK, Mull HJ, Kaafarani HMA, Nebeker JR, Shimada S, Helwig A, et al. Applying trigger tools to detect adverse events associated with outpatient surgery. J Patient Saf. 2011;7:45–59.

    Article  PubMed  Google Scholar 

  20. Klopotowska JE, Wierenga PC, Stuijt CCM, Arisz L, Dijkgraaf MGW, Kuks PFM, et al. Adverse drug events in older hospitalized patients: results and reliability of a comprehensive and structured identification strategy. PLoS ONE. 2013;8:e71045.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  21. Carnevali L, Krug B, Amant F, Van Pee D, Gérard V, de Béthune X, et al. Performance of the adverse drug event trigger tool and the global trigger tool for identifying adverse drug events: experience in a Belgian hospital. Ann Pharmacother. 2013;47:1414–9.

    Article  PubMed  Google Scholar 

  22. Franklin BD, Birch S, Schachter M, Barber N. Testing a trigger tool as a method of detecting harm from medication errors in a UK hospital: a pilot study. Int J Pharm Pract. 2010;18:305–11.

    Article  PubMed  Google Scholar 

  23. Kalenderian E, Walji MF, Tavares A, Ramoni RB. An adverse event trigger tool in dentistry: a new methodology for measuring harm in the dental office. J Am Dent Assoc. 2013;144:808–14.

    Article  PubMed  Google Scholar 

  24. Hakkarainen KM, Andersson Sundell K, Petzold M, Hägg S. Methods for assessing the preventability of adverse drug events: a systematic review. Drug Saf. 2012;35:105–26.

    Article  PubMed  Google Scholar 

  25. Mattsson TO, Knudsen JL, Lauritsen J, Brixen K, Herrstedt J. Assessment of the global trigger tool to measure, monitor and evaluate patient safety in cancer patients: reliability concerns are raised. BMJ Qual Saf. 2013;22:571–9.

    Article  PubMed  Google Scholar 

  26. Hébert G, Netzer F, Ferrua M, Ducreux M, Lemare F, Minvielle E. Evaluating iatrogenic prescribing: development of an oncology-focused trigger tool. Eur J Cancer. 2015;51:427–35.

    Article  PubMed  Google Scholar 

  27. Winterstein AG, Hatton RC, Gonzalez-Rothi R, Johns TE, Segal R. Identifying clinically significant preventable adverse drug events through a hospital’s database of adverse drug reaction reports. Am J Health Syst Pharm. 2002;59:1742–9.

    PubMed  Google Scholar 

  28. Fitch K, Bernstein S, Aguilar M, Burnand B, LaCalle J, Lazaro P. The RAND/UCLA appropriateness method user’s manual. California: Santa Monica; 2001.

    Google Scholar 

  29. National Institutes of Health, National Cancer Institute. Common Terminology Criteria for Adverse Events (CTCAE) Version 4.03 [Internet]. 2010. http://www.evs.nci.nih.gov/ftp1/CTCAE/CTCAE_4.03_2010-06-14_QuickReference_5x7.pdf.

  30. Bégaud B, Evreux JC, Jouglard J, Lagier G. Imputation of the unexpected or toxic effects of drugs. Actualization of the method used in France. Therapie. 1985;40:111–8.

    PubMed  Google Scholar 

  31. Dangoumau J, Evreux JC, Jouglard J. Method for determination of undesirable effects of drugs. Therapie. 1978;33:373–81.

    CAS  PubMed  Google Scholar 

  32. Kaafarani HMA, Rosen AK, Nebeker JR, Shimada S, Mull HJ, Rivard PE, et al. Development of trigger tools for surveillance of adverse events in ambulatory surgery. Qual Saf Health Care. 2010;19:425–9.

    PubMed  Google Scholar 

  33. Bourrée F, Michel P, Salmi LR. Méthodes de consensus: revue des méthodes originales et de leurs grandes variantes utilisées en santé publique. Rev Epidemiol Sante Publique. 2008;56:415–23.

    Article  PubMed  PubMed Central  Google Scholar 

  34. Grenier-Sennelier C, Corriol C, Daucourt V, Michel P, Minvielle E. Développement d’indicateurs de qualité au sein des établissements de santé: le projet COMPAQH. Rev Epidemiol Sante Publique. 2005;53:22–30.

    Article  Google Scholar 

  35. Handler SM, Hanlon JT, Perera S, Roumani YF, Nace DA, Fridsma DB, et al. Consensus list of signals to detect potential adverse drug reactions in nursing homes. J Am Geriatr Soc. 2008;56:808–15.

    Article  PubMed  PubMed Central  Google Scholar 

  36. Mull HJ, Nebeker JR, Shimada SL, Kaafarani HMA, Rivard PE, Rosen AK. Consensus building for development of outpatient adverse drug event triggers. J Patient Saf. 2011;7:66–71.

    Article  PubMed  PubMed Central  Google Scholar 

  37. Unbeck M, Lindemalm S, Nydert P, Ygge B-M, Nylén U, Berglund C, et al. Validation of triggers and development of a pediatric trigger tool to identify adverse events. BMC Health Serv Res. 2014;14:655.

    Article  PubMed  PubMed Central  Google Scholar 

  38. de Wet C, Bowie P. The preliminary development and testing of a global trigger tool to detect error and patient harm in primary-care records. Postgrad Med J. 2009;85:176–80.

    Article  PubMed  Google Scholar 

  39. Miller L, Bainbridge D, Jordan C, Jolley H, Primary T. 1000 Lives Plus: How use Trigger Tool [Internet]. 2010. www.1000livesplus.wales.nhs.uk/opendoc/179568.

  40. Leape LL, Brennan TA, Laird N, Lawthers AG, Localio AR, Barnes BA, et al. The nature of adverse events in hospitalized patients. Results of the Harvard Medical Practice Study II. N Engl J Med. 1991;324:377–84.

    Article  CAS  PubMed  Google Scholar 

  41. Olivier P, Caron J, Haramburu F, Imbs J-L, Jonville-Béra A-P, Lagier G, et al. Validation d’une échelle de mesure: exemple de l’échelle française d’évitabilité des effets indésirables médicamenteux. Therapie. 2005;60:39–45.

    Article  PubMed  Google Scholar 

  42. Ransohoff DF, Pignone M, Sox HC. How to decide whether a clinical practice guideline is trustworthy. JAMA. 2013;309:139–40.

    Article  CAS  PubMed  Google Scholar 

  43. Aapro MS, Bohlius J, Cameron DA, Dal Lago L, Donnelly JP, Kearney N, et al. 2010 update of EORTC guidelines for the use of granulocyte-colony stimulating factor to reduce the incidence of chemotherapy-induced febrile neutropenia in adult patients with lymphoproliferative disorders and solid tumours. Eur J Cancer. 2011;47:8–32.

    Article  CAS  PubMed  Google Scholar 

  44. de Naurois J, Novitzky-Basso I, Gill MJ, Marti FM, Cullen MH, Roila F, et al. Management of febrile neutropenia: ESMO clinical practice guidelines. Ann Oncol. 2010;21(Suppl 5):v252–6.

    Article  PubMed  Google Scholar 

  45. Flowers CR, Seidenfeld J, Bow EJ, Karten C, Gleason C, Hawley DK, et al. Antimicrobial prophylaxis and outpatient management of fever and neutropenia in adults treated for malignancy: American society of clinical oncology clinical practice guideline. J Clin Oncol. 2013;31:794–810.

    Article  PubMed  Google Scholar 

  46. Gandhi TK, Seger AC, Overhage JM, Murray MD, Hope C, Fiskio J, et al. Outpatient adverse drug events identified by screening electronic health records. J Patient Saf. 2010;6:91–6.

    Article  PubMed  Google Scholar 

  47. Jha AK, Laguette J, Seger AC, Bates DW. Can surveillance systems identify and avert adverse drug events? A prospective evaluation of a commercial application. J Am Med Inform Assoc. 2008;15:647–53.

    Article  PubMed  PubMed Central  Google Scholar 

  48. Classen DC, Burke JP, Pestotnik SL, Evans RS, Stevens LE. Surveillance for quality assessment: IV. Surveillance using a hospital information system. Infect Control Hosp Epidemiol. 1991;12:239–44.

    Article  CAS  PubMed  Google Scholar 

Download references

Funding

The study was funded by the Directorate of Health Care Supply of the French Ministry of Health.

Conflicts of interest

The authors declare no conflicts of interest with the content of the article.

IATRIGGER Working Group

Dr Elias Assaf, Dr Christophe Bardin, Dr Florence Basuyau, Prof. Pierrick Bedouch, Dr Dominique Charlety, Dr Nathalie Contentin, Dr Mikael Daouphars, Prof. Frédéric Di Fiore, Dr Ludovic Doucet, Dr Cécile Guillemet, Dr Anne-Chrisitine Joly, Dr Charlotte Joly, Dr Fabien Le Bras, Dr Marianne Leheurteur, Dr Marion Lottin, Dr Mélodie Lucas, Dr Isabelle Madelaine, Prof. Véronique Merle, Dr Nathalie Pons-Kerjean, Dr Jordi Remon-Masip, Dr Benoit Rousseau, Dr Jean Rouvet, Dr Caroline Saldana, Dr Florian Slimano, Dr Anne-Claire Toffart, Prof. Christophe Tournigand, Prof. Remi Varin, Dr Anne Vekhoff and Dr Muriel Verlinde-Carvalho.

Author information

Authors and Affiliations

Authors

Consortia

Corresponding author

Correspondence to Guillaume Hébert.

Additional information

François Lemare and Etienne Minvielle should be considered joint last authors.

Electronic supplementary material

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Hébert, G., Netzer, F., Kouakou, S.L. et al. Development of a ‘ready-to-use’ tool that includes preventability, for the assessment of adverse drug events in oncology. Int J Clin Pharm 40, 376–385 (2018). https://doi.org/10.1007/s11096-017-0542-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11096-017-0542-3

Keywords

Navigation