There are limited data on the characterization of medication-related visits (MRVs) to the emergency department (ED) in pediatric patients in Italy. We have estimated the frequency, severity, and classification of MRVs to the ED in pediatric patients.
We retrospectively analyzed data for children seeking medical evaluation for a MRV over an 8 years period. A medication-related ED visit was identified by using a random pharmacist assessment, emergency physician assessment, and in case of conflicting events, by a third investigators random assessment.
In this study, regarding a single tertiary center in Italy, on a total of 147,643 patients from 0 to 14 years old, 497 medication-related visits were found, 54% of which occurred in children from 0 to 2 years of age. Severity was classified as mild in 21.6% of cases, moderate in 67.2% of cases, and severe in 11.2% of cases. The most common events were related to drug use without indication (51%), adverse drug reactions (30.3%), supratherapeutic dosage (13.2%) and improper drug selection (4.5%).
The medication classes most frequently implicated in an ADE were anti-infective drugs for systemic use (28.9%), central nervous system agents (22.3%) and respiratory system drugs (10.8%).
The most common symptom manifestations were dermatologic conditions (46.1%), general disorder and administration site conditions (29.7%) and gastrointestinal symptoms (16.0%).
To our knowledge, this is the first study in Italy evaluating the epidemiologic characteristics of MRVs confirming a significant cause of healthcare contact resulting in ED visits and hospital admissions with associated resource utilization. Our results suggests further future prospective, large-sample sized, and multicenter research is necessary to better understand the impact of MRVs and to develop strategies to provide care plans and monitor patients to prevent medication-related visits.
Ernst FR, Grizzle AJ. Drug-related morbidity and mortality: updating the cost-of-illness model. J Am Pharm Assoc. 2001;41(2):192–9. CrossRef
Nelson KM, Talbert RL. Drug-related hospital admissions. Pharmacotherapy. 1996;16(4):701–7. PubMed
Aparasu RR. Drug-related-injury visits to hospital emergency departments. American journal of health-system pharmacy. AJHP. 1998;55(11):1158–61. PubMed
Aparasu RR. Visits to office-based physicians in the United States for medication-related morbidity. J Am Pharm Assoc. 1999;39(3):332–7. CrossRef
Aparasu RR, Helgeland DL. Utilization of ambulatory care services caused by adverse effects of medications in the United States. Manag Care Interface. 2000;13(4):70–5. PubMed
Smith KM, McAdams JW, Frenia ML, Todd MW. Drug-related problems in emergency department patients. AJHP. 1997;54(3):295–8. PubMed
Schneitman-McIntire O, Farnen TA, Gordon N, Chan J, Toy WA. Medication misadventures resulting in emergency department visits at and HMO medical center. AJHP. 1996;53(12):1416–22. PubMed
Dennehy CE, Kishi DT, Louie C. Drug-related illness in emergency department patients. Am J Health Syst. 1996;53(12):1422–6.
Stoukides CA, D'Agostino PR, Kaufman MB. Adverse drug reaction surveillance in an emergency room. Am J Hosp Pharm. 1993;50(4):712–4. PubMed
Prince BS, Goetz CM, Rihn TL, Olsky M. Drug-related emergency department visits and hospital admissions. Am J Hosp Pharm. 1992;49(7):1696–700. PubMed
Leendertse AJ, Egberts AC, Stoker LJ, van den Bemt PM, Group HS. Frequency of and risk factors for preventable medication-related hospital admissions in the Netherlands. Arch Intern Med. 2008;168(17):1890–6. PubMed
Forster AJ, Clark HD, Menard A, Dupuis N, Chernish R, Chandok N, et al. Adverse events among medical patients after discharge from hospital. Can Med Assoc J. 2004;170(3):345–9.
Hepler CD, Strand LM. Opportunities and responsibilities in pharmaceutical care. Am J Hosp Pharm. 1990;47(3):533–43. PubMed
Strand LM, Morley PC, Cipolle RJ, Ramsey R, Lamsam GD. Drug-related problems: their structure and function. Ann Pharmacother. 1990;24(11):1093–7.
International drug monitoring. The role of the hospital. World Health Organ Tech Rep Ser. 1969;425:5–24. http://apps.who.int/iris/bitstream/10665/40747/1/WHO_TRS_425.pdf. Accessed 13 Nov 2016
Lamabadusuriya SP, Sathiadas G. Adverse drug reactions in children requiring hospital admission. Ceylon Med J. 2003;48(3):86–7. PubMed
Easton KL, Parsons BJ, Starr M, Brien JE. The incidence of drug-related problems as a cause of hospital admissions in children. Med J Aust. 1998;169(7):356–9. PubMed
Kozer E, Berkovitch M, Koren G. Medication errors in children. Pediatr Clin N Am. 2006;53(6):1155–68. CrossRef
Centers for Disease Control and Prevention. The PROTECT initiative: advancing children’s medication safety. 2012. http://www.cdc.gov/medicationsafety/protect/protect_initiative.html. Accessed 2 July.
- Medication-related visits in a pediatric emergency department: an 8-years retrospective analysis
Cinzia Del Giovane
- BioMed Central
Neu im Fachgebiet Pädiatrie
Meistgelesene Bücher aus dem Fachgebiet
Mail Icon II