Multicentric study on the incidence and preventability of medication-related incidents in patients visiting pediatric emergency departments

Abstract

ObjectiveTo determine the incidence, severity, and preventability of medication-related incidents in patients visiting pediatric emergency departments, and to identify the highest-risk age groups and the drugs most frequently involved. MethodThis is a multicenter prospective observational study carried out between March and June 2017 in patients between 0 and 16 years of age who visited the pediatric emergency department of eight Spanish public hospitals. We recorded and assessed three different types of incidents: adverse drug events, medication errors, and accidental self-poisoning. Incidents were characterized according to severity, preventability, age groups affected, and drugs involved. ResultsDuring the study period, a total of 99,797 visits were recorded to the pediatric emergency departments following 334 drug-related incidents in as many patients, of whom 52.4% were male, with a mean age of 47.1 ± 44.4 months. The incidence of patients with drug-related incidents was 0.3%. Of the total incidents, 264 (79%) were considered preventable and 158 (47.3%) had caused harm to patients. Incidents detected included 144 (43.1%) adverse drug events, 218 (65.2%) medication errors (74 of them leading to harm; these are also included as preventable drug-related adverse events), and 46 (13.7%) cases of accidental self-poisoning. Preschoolers (1-5 years of age) represented 60.8% of incidents and were the age group with the highest percentage of preventable incidents (64%). A total of 351 drugs were involved in the 334 incidents detected, most of which fell into one of three therapeutic groups: anti-infectives for systemic use (171; 48.7%), nervous system (66; 18.8%) and respiratory system (41; 11.7%). ConclusionsThe incidence of drug-related incidents in pediatric patients presenting to emergency departments was lower than that reported for adult patients, although almost half of the incidents identified were associated with harm. Preschool patients (1-5 years of age) were identified as the age group at the highest risk. The recorded incidents were caused by a small number of drugs. A high percentage of incidents were preventable, which confirms the urgent need to implement medication incident prevention strategies for this population.