Profile of adverse drug events in depressed inpatients in China and
associated risk factors: a retrospective review using the Global Trigger
Objective: The aim of the study was to evaluate the feasibility and
potential of the Global Trigger Tool (GTT) for identifying the adverse
drug events (ADEs) in patients with depression. Methods: In this study,
the trigger items for antidepressants were developed base on the
‘Institute for Healthcare Improvement (IHI) GTT for Measuring Adverse
Events’ . Trigger detection of the medical records was carried out in
200 patients diagnosed with depression in a specialized hospital. Each
medical record with the presence of any of the triggers was reviewed by
two researchers respectively to determine whether it was an ADE, if so,
ADE should be classified in severity, and involved system and primary
suspected drug were identified. Logistic regression was performed to
investigate risk factors associated with ADEs, and ADE detection rate
and positive predictive value (PPV) were calculated to evaluate the
sensitivity and specificity of the triggers. Results: Triggers were
detected for 162 times in 159 cases (79.5%), and 69 ADEs in 61 patients
were identified by record reviewing. the PPV of the trigger tool was
42.59%. 79.7% were classified as category E, and 20.30% category F.
ADEs were most likely to involve metabolic system (34.78%), manifested
as hypokalemia, pathoglycemia and hypercholesterolemia. venlafaxine was
most likely to cause AEs (32.56%), followed by paroxetine (22.09%).
Risk factors for ADEs included the number of administrated
antidepressants (p=0.008) and the number of concomitant drugs (p=0.014).
Conclusion: The GTT is a feasible and effective tool for detecting ADEs
of antidepressants for inpatients.