Application of Global Trigger Tool in monitoring antineoplastic adverse drug events: A retrospective study
Nrupal C. Patel, Aarmin I. Shaikh, Mayur A. Chaudhari, Chetankumar R. AcharyaAbstract
Introduction:
Antineoplastic drugs are frequently associated with adverse drug reactions (ADRs), and traditional spontaneous reporting often underestimates their true burden. The Institute for Healthcare Improvement (IHI) Global Trigger Tool (GTT) offers an active method for ADR detection. This study evaluated the usefulness of the GTT in identifying ADRs in oncology patients at a tertiary care hospital in South Gujarat.
Materials and Methods:
A retrospective observational study was conducted using 100 randomly selected inpatient records from a cancer institute. A preliminary trigger tool list containing 63 triggers was developed by adapting the IHI GTT and published oncology trigger lists. Patient records, laboratory data, treatment charts, and discharge summaries were reviewed for trigger identification. Each trigger was categorized as positive or negative, and its positive predictive value (PPV) was calculated. Identified ADRs were assessed using the World Health Organization–Uppsala Monitoring Centre and Naranjo Causality Scales and graded for severity using the Modified Hartwig and Siegel Scale. Statistical analysis was performed using SPSS v26.
Results:
Among 332 triggers identified, 140 (42.2%) were positive. The highest PPV was seen for fall (100%) and diarrhea (87.5%). A total of 140 ADRs were detected, most commonly anemia and leukopenia. ADRs were mainly mild (50.77%) or moderate (49.23%). A significant association existed between the number of triggers per patient and ADR occurrence (
Conclusion:
The GTT effectively identified antineoplastic-related ADRs and demonstrated strong utility as an active surveillance tool. Its integration into routine oncology practice may enhance early detection of ADR and improve patient safety.