TY - JOUR
T1 - Medication-related emergency department visits and hospital admissions in pediatric patients
T2 - A qualitative systematic review
AU - Zed, Peter J.
AU - Haughn, Christopher
AU - Black, Karen J.L.
AU - Fitzpatrick, Eleanor A.
AU - Ackroyd-Stolarz, Stacy
AU - Murphy, Nancy G.
AU - Mackinnon, Neil J.
AU - Curran, Janet A.
AU - Sinclair, Doug
N1 - Funding Information:
C.H. was supported by the Drug Evaluation Alliance of Nova Scotia ( Summer Student Research grant), Nova Scotia Department of Health . The authors declare no conflicts of interest.
PY - 2013/8
Y1 - 2013/8
N2 - Objective: To review and describe the current literature pertaining to the incidence, classification, severity, preventability, and impact of medication-related emergency department (ED) and hospital admissions in pediatric patients. Study design: A systematic search of PubMED, Embase, and Web of Science was performed using the following terms: drug toxicity, adverse drug event, medication error, emergency department, ambulatory care, and outpatient clinic. Additional articles were identified by a manual search of cited references. English language, full-reports of pediatric (≤18 years) patients that required an ED visit or hospital admission secondary to an adverse drug event (ADE) were included. Results: We included 11 studies that reported medication-related ED visit or hospital admission in pediatric patients. Incidence of medication-related ED visits and hospital admissions ranged from 0.5%-3.3% and 0.16%-4.3%, respectively, of which 20.3%-66.7% were deemed preventable. Among ED visits, 5.1%-22.1% of patients were admitted to hospital, with a length of stay of 24-72 hours. The majority of ADEs were deemed moderate in severity. Types of ADEs included adverse drug reactions, allergic reactions, overdose, medication use with no indication, wrong drug prescribed, and patient not receiving a drug for an indication. Common causative agents included respiratory drugs, antimicrobials, central nervous system drugs, analgesics, hormones, cardiovascular drugs, and vaccines. Conclusion: Medication-related ED visits and hospital admissions are common in pediatric patients, many of which are preventable. These ADEs result in significant healthcare utilization.
AB - Objective: To review and describe the current literature pertaining to the incidence, classification, severity, preventability, and impact of medication-related emergency department (ED) and hospital admissions in pediatric patients. Study design: A systematic search of PubMED, Embase, and Web of Science was performed using the following terms: drug toxicity, adverse drug event, medication error, emergency department, ambulatory care, and outpatient clinic. Additional articles were identified by a manual search of cited references. English language, full-reports of pediatric (≤18 years) patients that required an ED visit or hospital admission secondary to an adverse drug event (ADE) were included. Results: We included 11 studies that reported medication-related ED visit or hospital admission in pediatric patients. Incidence of medication-related ED visits and hospital admissions ranged from 0.5%-3.3% and 0.16%-4.3%, respectively, of which 20.3%-66.7% were deemed preventable. Among ED visits, 5.1%-22.1% of patients were admitted to hospital, with a length of stay of 24-72 hours. The majority of ADEs were deemed moderate in severity. Types of ADEs included adverse drug reactions, allergic reactions, overdose, medication use with no indication, wrong drug prescribed, and patient not receiving a drug for an indication. Common causative agents included respiratory drugs, antimicrobials, central nervous system drugs, analgesics, hormones, cardiovascular drugs, and vaccines. Conclusion: Medication-related ED visits and hospital admissions are common in pediatric patients, many of which are preventable. These ADEs result in significant healthcare utilization.
KW - ADE
KW - ADR
KW - ADRE
KW - Adverse drug event
KW - Adverse drug reaction
KW - Adverse drug-related event
KW - CNS
KW - Central nervous system
KW - ED
KW - Emergency department
KW - ICU
KW - Intensive care unit
UR - http://www.scopus.com/inward/record.url?scp=84880640765&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84880640765&partnerID=8YFLogxK
U2 - 10.1016/j.jpeds.2013.01.042
DO - 10.1016/j.jpeds.2013.01.042
M3 - Article
C2 - 23465404
AN - SCOPUS:84880640765
SN - 0022-3476
VL - 163
SP - 477
EP - 483
JO - Journal of Pediatrics
JF - Journal of Pediatrics
IS - 2
ER -