Trends in Emergency Department Visits for Unsupervised Pediatric Medication Exposures, 2004-2013

被引:60
作者
Lovegrove, Maribeth C. [1 ]
Weidle, Nina J. [2 ]
Budnitz, Daniel S. [1 ]
机构
[1] Ctr Dis Control & Prevent, Div Healthcare Qual Promot, Atlanta, GA 30333 USA
[2] Chenega Govt Consulting, Atlanta, GA USA
关键词
AMERICAN ASSOCIATION; SURVEILLANCE; INGESTIONS;
D O I
10.1542/peds.2015-2092
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
BACKGROUND: After reports of increasing emergency department (ED) visits for unsupervised abstract pediatric medication exposures in the 2000s, renewed efforts to improve safety packaging and education were initiated. National data on current trends can help further target interventions. METHODS: We used nationally representative data from the National Electronic Injury Surveillance System-Cooperative Adverse Drug Event Surveillance project (2004-2013) to assess trends in ED visits for unsupervised medication exposures in children aged <6 years. For 2010 through 2013, the dosage form and prescription status of implicated medications were identified. RESULTS: Based on 13 268 cases, there were an estimated 640 161 ED visits (95% confidence interval: 512 885 to 767 436) for unsupervised medication exposures from 2004 through 2013. From 2004 through 2010, ED visits for unsupervised exposures increased by an average of 5.7% annually, peaking at 75 842. After 2010, this trend reversed, and visits decreased by an average of 6.7% annually to 59 092 in 2013. From 2010 through 2013, 91.0% of unsupervised exposure visits involved 1 medication, most commonly an oral prescription solid (45.9%), oral over-the-counter (OTC) solid (22.3%), or oral OTC liquid (12.4%). More than 260 different prescription solids were implicated; opioids (13.8%) and benzodiazepines (12.7%) were the most common classes. Four medications were implicated in 91.2% of OTC liquid exposure visits: acetaminophen (32.9%), cough and cold remedies (27.5%), ibuprofen (15.7%), and diphenhydramine (15.6%). CONCLUSIONS: Targeting prevention efforts based on harm frequency and intervention feasibility can lead to continued reductions in ED visits for pediatric medication exposures.
引用
收藏
页码:E821 / E829
页数:9
相关论文
共 31 条
[1]   A Brief Educational Intervention Improves Medication Safety Knowledge in Grandparents of Young Children [J].
Agarwal, Maneesha ;
Williams, Janice ;
Tavoulareas, Demetrios ;
Studnek, Jonathan R. .
AIMS PUBLIC HEALTH, 2015, 2 (01) :44-55
[2]  
American Academy of Pediatrics, MED SAF VID
[3]  
[Anonymous], Orange book: Approved drug products with therapeutic equivalence evaluations
[4]  
[Anonymous], PHARMACOEPIDEMIOLOGY
[5]  
Baker JM, 2012, SAFE STORAGE SAFE DO
[6]   The Growing Impact of Pediatric Pharmaceutical Poisoning [J].
Bond, G. Randall ;
Woodward, Randall W. ;
Ho, Mona .
JOURNAL OF PEDIATRICS, 2012, 160 (02) :265-U312
[7]   2011 Annual Report of the American Association of Poison Control Centers' National Poison Data System (NPDS): 29th Annual Report [J].
Bronstein, Alvin C. ;
Spyker, Daniel A. ;
Cantilena, Louis R., Jr. ;
Rumack, Barry H. ;
Dart, Richard C. .
CLINICAL TOXICOLOGY, 2012, 50 (10) :911-1164
[8]   National surveillance of emergency department visits for outpatient adverse drug events [J].
Budnitz, Daniel S. ;
Pollock, Daniel A. ;
Weidenbach, Kelly N. ;
Mendelsohn, Aaron B. ;
Schroeder, Thomas J. ;
Annest, Joseph L. .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2006, 296 (15) :1858-1866
[9]   The Last Mile: Taking the Final Steps in Preventing Pediatric Pharmaceutical Poisonings [J].
Budnitz, Daniel S. ;
Lovegrove, Maribeth C. .
JOURNAL OF PEDIATRICS, 2012, 160 (02) :190-192
[10]   Preventing Medication Overdoses in Young Children: An Opportunity for Harm Elimination [J].
Budnitz, Daniel S. ;
Salis, Spencer .
PEDIATRICS, 2011, 127 (06) :E1597-E1599