Medication Overdoses Leading to Emergency Department Visits Among Children

• Published in: American journal of preventive medicine Vol. 37; no. 3; pp. 181 - 187
• Main Authors: Schillie, Sarah F., MD, Shehab, Nadine, PharmD, Thomas, Karen E., MPH, Budnitz, Daniel S., MD
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Inc 01.09.2009
• Subjects: Accident and emergency departments; Adolescent; Adverse Drug Reaction Reporting Systems; Child; Child, Preschool; Children; Consumer products; Drug Overdose - epidemiology; Drug-Related Side Effects and Adverse Reactions - epidemiology; Emergency Service, Hospital - statistics & numerical data; Female; Humans; Infant; Internal Medicine; Male; Overdoses; Paediatrics; Poisoning; Population Surveillance; Prevalence; United States - epidemiology; United States
• ISSN: 0749-3797; 1873-2607
• DOI: 10.1016/j.amepre.2009.05.018

Background The high prevalence of medication use increases the potential for medication overdoses, especially among children. Purpose This paper describes the burden of unintentional pediatric medication overdoses in order to target new prevention efforts. Methods Data were analyzed in 2007 and 2008 from the National Electronic Injury Surveillance System, collected January 1, 2004, through December 31, 2005, to estimate the number of emergency department visits resulting from unintentional medication overdoses among children aged ≤18 years in the U.S. These data were analyzed by patient demographics, overdose cause, and implicated products, and compared to visits for nonpharmaceutical consumer product poisonings. Results Based on 3034 cases, an estimated 71,224 emergency department visits for medication overdoses were made annually by children aged ≤18 years, representing 68.9% of emergency department visits for unintentional pediatric poisonings. The rate of unintentional poisonings from medications was twice the rate of those from nonpharmaceutical consumer products (9.2 visits per 10,000 individuals per year [95% CI=7.3, 11.0] vs 4.2 per 10,000 individuals per year [95% CI=3.3, 5.0]). Four fifths (82.2%) of visits for medication overdoses were from unsupervised ingestions (children accessing medications on their own); medication errors and misuse resulted in 14.3% of visits. Most visits (81.3%) involved children aged ≤5 years, and commonly available over-the-counter medications were implicated in one third (33.9%) of visits. Conclusions Medication overdoses among children, notably unsupervised ingestions, represent a substantial burden in terms of emergency department visits and hospitalizations. New efforts to prevent pediatric medication overdoses are needed.