Serum potassium level used as trigger doubled the detection of adverse drug events when compared with calcium polystyrene sulfonate trigger: a cross-sectional study
Rev. ciênc. farm. básica apl
;
42: 1-12, 20210101.
Article
in English
|
LILACS-Express
| LILACS
| ID: biblio-1223264
ABSTRACT
Background:
Prescription of calcium polystyrene sulfonate (CPS) has been considered a trigger with good performance to detect hyperkalemia related to adverse drug events (ADE). However, CPS prescription may underestimate the rate of ADE.Objective:
To compare the performance of the serum potassium level (SPL) >5.0mEq/L and CPS triggers in detecting hyperkalemia related to ADE. Design andsetting:
A six-month cross-sectional study was conducted in a Brazilian medium-complexity public hospital.Methods:
SPL Tests with results >5.0mEq/L and the prescriptions of CPS of all patients hospitalized in the internal medicine and infectious diseases wards were used as trigger tools to detect potential ADE. Primaryoutcome:
patients with hyperkalemia related to ADE. Secondaryoutcomes:
effectiveness of treatments and ADE. Variables analyzed were SPL tests, CPS prescriptions, treatments of hyperkalemia and comorbidities. Positive predictive values (PPV) of CPS and SPL triggers were calculated and compared.Results:
In total 2,466 SPL tests were assessed, of which 513 were triggered (>5.0mEq/L). The tests triggered 198 patients with hyperkalemia, of whom 121 had hyperkalemia related to ADE (PPV=0.61). In total, 101 CPS prescriptions triggered tests in 35 patients with hyperkalemia, among whom 21 cases were related to ADE (PPV=0.60). SPL detected 204 ADE (PPV=0.40), while CPS prescription detected 22 (PPV=0.21). Seven pharmacological and four non-pharmacological treatments were identified. CPS showed the lowest effectiveness (PPV=0.71).Conclusion:
SPL>5.0mEq/L increased the detection of ADE by 9.3-fold, the number of patients tracked with hyperkalemia related to ADE by 5.8-fold, and doubled the performance in detection of ADE in comparison with the prescription of the CPS trigger.
Full text:
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Index:
LILACS (Americas)
Type of study:
Diagnostic study
/
Observational study
/
Prevalence study
/
Prognostic study
/
Risk factors
Language:
English
Journal:
Rev. ciênc. farm. básica apl
Journal subject:
Pharmacology
Year:
2021
Type:
Article
Affiliation country:
Brazil
Institution/Affiliation country:
Department of Drugs and Medicines/BR
/
Department of Public Health/BR
/
University of São Paulo/BR
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