Trackers for Adverse Events in Child Mental Health
descriptive analysis using the global trigger tool
DOI:
https://doi.org/10.1590/Keywords:
Drug-related side effects and adverse reactions, Psychotropic drugs, ChildAbstract
The goal of this study is to identify the global trigger tool trackers used to place the adverse drug events presented in children that use psychotropic drugs accompanied by Child-adolescent Psychosocial Care Centers. This is a descriptive study carried out with the secondary data of 112 child care records that began in January 2017 in two Child-adolescent Psychosocial Care Centers. A median of medicine per child was 1.71 and among the most used we were to risperidone 100%, followed by valproic acid and periciazine with 16% each. A total of 42 adverse drug events were found in 36 medical records, being agitation 29.7% and agressive 16.2%, being the most frequent, and in 45.2% of infants presenting only one event. 50 were trackers detected in 83.3%, two records that identified adverse drug events. In 38.8% were found only one tracker, the most found ones were: combination of psychotropic medicines 32%, abrupt reduction of medicine dose 22% and abrupt cessation of medicine 12%. Finally, the present study showed that the global trigger tool evidenced adverse drug events by means of the detection of trackers in children and that it had to offer interventions to improve the quality of psychiatric therapy within two community services.
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Abrantes ARM. Efeitos da risperidona no aumento e distribuição de peso e nos níveis de hemoglobina AIC numa amostra de crianças e adolescentes com autismo: estudo longitudinal de um ano. Faculdade de Medicina da Universidade de Coimbra Portugal, 2015.
Bayer SS, Clark C, Dang O, Aberdeen J, Brajovic S, Swank K, et al. ADE Eval: An Evaluation of Text Processing Systems for Adverse Event Extraction from Drug Labels for Pharmacovigilance. Drug Saf. 2021;44(5):83-94.
Borges FDS, Pretto CH, Bandeira VAC, Colet CF. Perfil de tratamento com psicofármacos de usuários de um centro de atenção psicossocial infanto-juvenil. Rev Saúde (St. Maria). 2020;46(1):1-14.
Brasil. Portaria Nº 1203, de 4 de novembro de 2014. Aprova o Protocolo Clínico e Diretrizes Terapêuticas do Transtorno Esquizoafetivo.
Brasil. Portaria Nº 344, de 12 de maio de 1998. Aprova o Regulamento Técnico sobre substâncias e medicamentos sujeitos a controle especial, 1998.
Coates M, Spanos M, Parmar P, Chandrasekhar T, Sikich L. A review of methods for monitoring adverse events in pediatric. Psychopharmacology clinical trials. Drug Saf. 2018;41(5):465-471.
Dinnissen M. Clinical and pharmacokinetic evaluation of risperidone for the management of autism spectrum disorder. Expert Opin Drug Metab Toxicol. 2015;11(1):111-24.
Egunsola O, Choonara I, Sammons HM, Whitehouse WP. Safety of antiepileptic drugs in children and young people: A prospective cohort study. Seizure. 2018;56:20-25.
Fajreldines A, Schnitzler E, Torres S, Panattieri N, Pellizzari M. Medición de la incidencia de eventos adversos atribuidos a la atención sanitaria en un Departamento de Pediatría de un hospital universitario. Arch Argent Pediatr. 2019;117(2):e106-e109.
Griffin FA, Resar RK. IHI Global Trigger Tool for Measuring Adverse Events. 2ª ed. IHI Innovation Series white paper. Cambridge, Massachusetts: Institute for Healthcare Improvement; 2009.
Hollis C, Chen Q, Chang Z, Quinn PD, Viktorin A, Lichtenstein P, et al. Methylphenidate and the risk of psychosis in adolescents and young adults: a population-based cohort study. Lancet Psychiatry. 2019;6(8):651-658.
Institute for Healthcare Improvement. Trigger Tool for Measuring Adverse Drug Events. Trigger Tool for Measuring Adverse Drug Events in a Mental Health Setting. Version 2, 2008. Available at: http://www.ihi.org/IHI/Topics/PatientSafety/MedicationSystems/Tools/Trigger+Tool+for+Measuring+Adverse+Drug+Events+%28IHI+Tool%29.htm
Ivashchenko D, Buromskaya N, Savchenko L, Shevchenko Y, Sychev D. Global trigger tool in child psychiatry: Treatment safety evaluation in adolescents with an acute psychotic episode. Int J Risk Saf Med. 2020;31(1):25-35.
Ji H, Song L, Xiao JW, Guo YX, Wei P, Tang TT, et al. Adverse drug events in Chinese pediatric inpatients and associated risk factors: a retrospective review using the Global Trigger Tool. Sci Rep. 2018;8(1):2573.
Lee CS, Williamson LR, Martin SE, DeMarco M, Majczak M, Martini J, et al. Adverse events in very young children prescribed psychotropic medications: Preliminary findings from an acute clinical sample. J Child Adolesc Psychopharmacol. 2015;25(6):509-13.
Leitao IB, Diasa AB, Tristão KG, Ronchia JP, Avellara LZ. Dez anos de um CAPSi: comparação da caracterização de usuários atendidos. Psicol USP. 2020;31:e190011.
Medhekar R, Aparasu R, Bhatara V, Johnson M, Alonzo J, Schwarzwald H, et al. Risk factors of psychotropic polypharmacy in the treatment of children and adolescents with psychiatric disorders. Res Social Adm Pharm. 2019;15(4):395-403.
Menard M, Thümmler S, Giannitelli M, Cruzel C, Bonnot O, Cohen D, et al. ETAPE Study Group. Incidence of adverse events in antipsychotic-naïve children and adolescents treated with antipsychotic drugs: Results of a multicenter naturalistic study (ETAPE). Eur Neuropsychopharmacol. 2019;29(12):1397-1407.
Micromedex® Healthcare Series: MICROMEDEX 2.0 [plataforma na Internet]. [acessado 2021 Abr 16]. Disponível em: Disponível em: http://www.periodicos.capes.gov.br ».
» http://www.periodicos.capes.gov.br
Molina-Castillo JJ, Leonés-Gil EM, López-Espuela F. Descriptive analysis of the admission of minors into a psychiatric unit. An Pediatr. 2021;94(1):11-18.
Nilsson L, Borgstedt-Risberg M, Brunner C, Nyberg U, Nylén U, Ålenius C, et al. Adverse events in psychiatry: a national cohort study in Sweden with a unique psychiatric trigger tool. BMC Psychiatry. 2020;20:44.
Palanca-Maresca I, Ruiz-Antorán B, Centeno-Soto G, Jiménez-Fernandez S, García-Murillo L, Siles A, et al. SENTIA: a systematic online monitoring registry for children and adolescents treated with antipsychotics. SpringerPlus. 2014;3(187):34-39.
Rosso E, Nimtz MA, Paes MR, Macedo M, Maftum MA, Alcantara CB. Vivência de familiares de crianças com transtornos mentais. Rev Enferm UFSM. 2020;10(36):1-20.
Rozenfeld S, Giordani F, Coelho, S. Eventos adversos a medicamentos em hospitais: estudo piloto com ferramenta de gatilho. Rev Saúde Pública. 2013;47(6):1102-1111.
Scahill LMSN, Jeon S, Boorin SJ, McDougle CJ, Aman MG, Dziura J, et al. Weight Gain and Metabolic Consequences of Risperidone in Young Children With Autism Spectrum Disorder. J Am Acad Child Adolesc Psychiatry. 2016;55(5):415-423.
Serafim MPS, Gomes KM, Silva DM, Brunél JL. Perfil das crianças usuárias do ambulatório de saúde mental do Município de Içara - SC. Est Inter Psicol. 2019;10(2):192-209.
Silva ORT, Silveira MM. O uso de psicofármacos por crianças e adolescentes em um Centro de Atenção Psicossocial Infantil. Infarma. 2019;31(3):32.
Silva SN, Lima MG, Ruas CM. Uso de medicamentos nos Centros de Atenção Psicossocial: análise das prescrições e perfil dos usuários em diferentes modalidades do serviço. Cien Saude Colet. 2020;25(7):2871-2882.
Solevåg AL, Nakstad B. Utility of a Paediatric Trigger Tool in a Norwegian department of paediatric and adolescent medicine. BMJ Open 2014;4(5):e005011.
Spina E, Leon J. Clinically relevant interactions between newer antidepressants and second-generation antipsychotics. Expert Opin Drug Metab Toxicol. 2014;10(5):721-46.
Vanwong N, Ngamsamut N, Nuntamool N, Hongkaew Y, Sukprasong R, Puangpetch A, et al. Risperidone-induced obesity in children and adolescents with autism spectrum disorder: Genetic and clinical risk factors. Front Pharmacol. 2020;4(2):55.
Vizotto LP, Ferrazza DA. A infância na berlinda: Sobre rotulações diagnósticas e a banalização da prescrição de psicofármacos. Estud psicol. 2017;22(2):214-224.
World Health Organization. WHO. Conceptual Framework for the International Classification for Patient Safety. Version 1.1. Final Technical Report. Chapter 3. The International Classification for Patient Safety. Key Concepts and Preferred Terms. WHO; 2009a.
World Health Organization. WHO. Collaborating Centre for Drugs Statistics Methodolosy. Anatomical Therapeutic Chemical Classifacation (ATC Code, 2009b). http://www.whocc.no/atcddd
World Health Organization. WHO. Pharmacovigilance indicators: a practical manual for the assessment of pharmacovigilance systems. Geneva: World Health Organization; 2015.
World Health Organization. WHO. Classifications. International Classification of Diseases (ICD). www.who.int Consultado em 19 de janeiro de 2021.
» www.who.int
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