Profile of adverse drug events in depressed inpatients in China and associated risk factors: a retrospective review using the Global Trigger Tool

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.