Risk Factors for Adverse Drug Events and Medication Errors in Paediatric Inpatients: Analysis by Admission Characteristics

Abstract

ABSTRACTBackgroundThere are few published data analysing risk factors for adverse drug events and medication errors in children.AimTo evaluate the factors that influence the risk of adverse drug events and medication errors occurring during a hospital admission for a child.MethodProspective cohort study of all paediatric admissions of at least 24 hours duration at Dunedin Hospital over a 12‐week period. Suspected events were identified via chart review, multidisciplinary ward meetings, parent interview and voluntary staff reporting. Hypothesis tests were performed using hazard ratios and 95% confidence intervals.Results495 patients were included who in total had 520 admissions. There were 67 adverse drug events, of which 38 (57%) were classified as preventable, 77 potential adverse drug events and 255 ‘no‐harm’ medication errors. On multivariate analysis, the major independent risk factors for adverse drug events were increasing age (HR 1.2; 95%CI 1.1–1.3) and a greater number of regular medications (HR 6; 95%CI 1.9–19.3). For potential adverse drug events, intravenous infusions conferred the highest risk (HR 32.4; 95%CI 10.9–95.5). For ‘no‐harm’ medication errors, greater duration of hospital admission (HR 1.2; 95%CI 1.1–1.3) and a greater number of regular medications (HR 14.6; 95%CI 6.4–33.2), particularly IV infusions (HR 13; 95%CI 2.9–56.9), were the main predictors of occurrence. Sex and weight were not found to be related to adverse drug events or medication errors in this cohort of hospitalised children.ConclusionA greater number of regular medications and intravenous infusions were important risk factors for adverse drug events and medication errors occurring during hospital admission for a child. Increasing age also influenced the risk of an adverse drug event, whereas for ‘no harm’ medication errors, a greater duration of hospital admission was important.