TABLE 3.
Prevalence, Sensitivity, Specificity, and Positive and Negative Predictive Values of Each Evaluated Trigger
| Prevalence | Sensitivity | Specificity | PPV | NPV | ||
|---|---|---|---|---|---|---|
| Trigger | n (%) | 95% CI | % (95% CI) | % (95% CI) | % (95% CI) | % (95% CI) |
| Change of assigned healthcare worker | 78 (4.3%) | (3.4%–5.2%) | 5.4% (0.8%–10.0%) | 95.7% (94.7%–96.7%) | 6.4% (1.0%–11.8%) | 94.9% (93.9%–95.9%) |
| ≥3 appointments in 1 wk at PC center | 152 (8.5%) | (7.2%–9.8%) | 32.3% (22.8%–41.8%) | 92.8% (91.6%–94.0%) | 19.7% (13.4%–26%) | 96.2% (95.3%–97.1%) |
| INR > 5 | 4 (0.2%) | (0%–0.4%) | 4.3% (0.2%–8.4%) | 100% (99.9%–100%) | 100% (21.2%–100%) | 95.0% (94.0%–96.0%) |
| Ictus/TIA | 1 (0.1%) | (0%–0.2%) | 0% (0%–0.1%) | 99.9% (99.75%–100%) | 0% (0%–87.1%) | 94.8% (93.8%–95.8%) |
| Pressure ulcer | 1 (0.1%) | (0%–0.2%) | 0% (0%–0.1%) | 99.9% (99.75%–100%) | 0% (0%–87.1%) | 94.8% (93.8%–95.8%) |
| Record of adverse reaction to medication | 1 (0.1%) | (0%–0.2%) | 0% (0%–0.1%) | 99.9% (99.75%–100%) | 0% (0%–87.1%) | 94.8% (93.8%–95.8%) |
| Bone fracture in patients ≥75 y old | 1 (0.1%) | (0%–0.2%) | 1.1% (0.0%–3.2%) | 100% (99.9%–100%) | 100% (17.2%–100%) | 94.9% (93.9%–95.9%) |
| Hospital admission | 65 (3.6%) | (2.7%–4.5%) | 19.4% (11.4%–27.4%) | 97.2% (96.4%–98.0%) | 27.7% (16.8%–38.6%) | 95.7% (94.7%–96.7%) |
| Readmission to hospital within 30 d | 3 (0.2%) | (0%–0.4%) | 2.2% (0.0%–5.2%) | 99.9% (99.75%–100%) | 66.7% (13.4%–100%) | 94.9% (93.9%–95.9%) |
| Hospital emergency department visits | 186 (10.4%) | (9.0%–11.8%) | 31.2% (21.8%–40.6%) | 90.8% (89.4%–92.2%) | 15.6% (10.4%–20.8%) | 96.0% (95.0%–97.0%) |
| ≥6 active prescriptions | 294 (16.4%) | (14.7%–18.1%) | 29.0% (19.8%–38.2%) | 84.3% (82.6%–86.0%) | 9.2% (5.9%–12.5%) | 95.6% (94.6%–96.6%) |
| Major opioids prescription | 6 (0.3%) | (0%–0.6%) | 2.2% (0.0%–5.2%) | 99.8% (99.6%–100%) | 33.3% (0.0%–71.0%) | 94.9% (93.9%–95.9%) |
| Chronic benzodiazepines treatment in patients ≥75 y old | 89 (5.0%) | (4.0%–6.0%) | 14% (6.9%–21.1%) | 95.5% (94.5%–96.5%) | 14.6% (7.3%–21.9%) | 95.3% (94.3%–96.3%) |
| Inappropriate medication in patients ≥75 y old | 199 (11.1%) | (9.6%–12.6%) | 20.4% (12.2%–28.6%) | 89.4% (87.9%–90.9%) | 9.5% (5.4%–13.6%) | 95.4% (94.4%–96.4%) |
Five of the triggers included in this study were not present in any EMR: prescription of nonsteroid anti-inflammatory drugs + angiotensin-converting enzyme inhibitors/angiotensin II receptor blockers + diuretics in patients ≥65 years of age; glycemia <50 mg/dL; hemoglobin <9 g/dL; glomerular filtration (estimated) < 30 mL/min; and potassium <3 or >6 mmol/L.
INR, international normalized ratio; TIA, transient ischemic attack.