Volume 3 • Issue 4 • 1000165 Adv Pharmacoepidemiol Drug Saf ISSN: 2167-1052 APDS, an open access journal Open Access Research Article Yerramilli et al., Adv Pharmacoepidemiol Drug Saf 2014, 3:4 DOI: 10.4172/2167-1052.1000165 Keywords: Adverse drug reactions; Tracer techniques; Triggers; Naranjo’s scale; Pharmacovigilance Introduction Te advent of newer medicines has changed the way in which diseases are managed. Despite their benefts, mounting evidence suggests that drug related Adverse Drug Reactions (ADRs) are common, yet ofen preventable, cause of illness, disability, death and add to the overall healthcare cost [1]. Early detection, evaluation and monitoring of ADRs are essential to reduce harm to patients and thereby improving public health [2]. Te detection of ADRs has become increasingly signifcant because of the introduction of a large number of newer medicines in the last two or three decades. World Health Organization (WHO) has intervened seriously in this regard and established an international ADR monitoring center at Uppsala, Sweden, which is collaborating with National monitoring centers in around 70 countries [3]. Adverse events occur in nearly one in ten hospitalizations with drug-related adverse events accounting for 15% of these [4]. Assessing the actual safety of drug use has been historically difcult, mainly because traditional methods such as chart audits and voluntary reporting of data which have been shown to be expensive, time consuming, insensitive, and largely inefective for detecting drug related ADRs. Computerized methods for detecting ADRs, employing “tracer drugs or triggers” in a patient’s medical record, are efective and relatively inexpensive [5]. A trigger tool is a simple checklist pro-forma containing a selected number of clinical ‘triggers’ which a reviewer *Corresponding author: Yerramilli A, Head of Department, Sri Venkateshwara College of Pharmacy, 86, Hitech City Road, Madhapur, Hyderabad, Andhra Pradesh, India, Tel: 9704231971; E-mail: svcppharmd.hod@gmail.com Received July 15, 2014; Accepted October 22, 2014; Published October 24, 2014 Citation: Yerramilli A, Veerla S, Chintala E, Guduguntla M, Velivelli P, et al. (2014) A Pharmacovigilance Study Using Tracer Techniques. Adv Pharmacoepidemiol Drug Saf 3: 165. doi:10.4172/2167-1052.1000165 Copyright: © 2014 Yerramilli A, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Abstract Objective: To identify adverse drug reactions by using a comprehensive trigger tool method. To categorize the identifed adverse drug reactions based upon their Probability, Severity, Harm and Preventability by using different scales. Methods: A single-center, Cross-sectional, observational study based on medication and laboratory trigger tool methodology was conducted over a period of six months. The World Health Organization defnition of adverse drug reactions was adopted. A list of 17 triggers were used to trace the adverse drug reactions which were then analyzed to assess the causality by using Naranjo’s scale, severity by Hartwig and Siegel scale, and harm by the National Coordinating Council for Medication Error Reporting and Preventing Index and preventability by Modifed Schumock and Thornton scale. Results: A total of 100 suspected ADRs were collected and analyzed. The drug classes most commonly implicated with ADRs were cephalosporins (25%) followed by anti-diabetic agents (19%). According to Naranjo’s scale, the reactions were categorized as probable (80%), possible (10%) and defnite (5%). According to the modifed Schumock and Thornton preventability scale, 20 cases (20%) were possibly preventable while 80 cases (80%) were not preventable. In 85 cases (85%) the suspected drug was withdrawn while in 10 cases (10%) no change in dose was made and in 5 cases (5%) the dose was altered. Conclusion: Pharmacovigilance using tracer techniques signifcantly increases the identifcation and reporting of ADRs. The tracer technique is relatively simple, sensitive, less expensive and largely effective compared to traditional methods. The Trigger tool provides an additional instrument in improving patient safety. This technique leads to an increase in awareness and reporting of ADRs and provide opportunities for the health care system to review drug selection and prescribing practices affecting patient outcomes. A Pharmacovigilance Study Using Tracer Techniques Yerramilli A 1 *, Veerla S 2 , Chintala E 2 , Guduguntla M 2 , Velivelli P 2 , Sharma S 3 and Paul R 4 1 Associate Professor, Sri Venkateshwara College of Pharmacy, Hyderabad, India 2 Pharm. D Interns, Sri Venkateshwara College of Pharmacy, Department of Pharmacy Practice, Osmania University, Hyderabad, India 3 Clinical Pharmacologist, Apollo Hospitals, Jubilee Hills, Hyderabad, India 4 General Medicine, Apollo Hospitals, Jubilee Hills, Hyderabad, India looks to identify while screening electronic medical records. ‘‘Triggers or Tracer drugs’’ are defned as easily identifable fags, occurrences or prompts in patient records that alert reviewers to potential adverse events which were previously undetected. Te trigger tool methodology is a prospective and retrospective review of a random sample of patient records using triggers to identify possible adverse events associated with patient care. Trigger tools provide clues that an ADR has occurred. It focuses on detecting, quantifying and tracking adverse outcomes over time. Te methodology is related to actual clinical injury. It can be used in all clinical environments to detect multiple types of Adverse Drug Event (ADE) [6]. Medication-related harm can be detected using a trigger tool methodology towards an adverse drug event. Medication-related triggers include the sudden withdrawal of a medication, a prescription for an antidote, or an abnormal laboratory test value [5]. Detecting Advances in Pharmacoepidemiology & Drug Safety A d v a n c e s i n P h a r m a c o e p i d e m i o l o g y & D r u g S a f e t y ISSN: 2167-1052