@article{3928,
  keywords = {adverse drug events, adverse drug reaction, adverse events, emergency department, hospitalization, patient safety, pediatrics},
  author = {Peter J. Zed and Karen J L Black and Eleanor A. Fitzpatrick and Stacy Ackroyd-Stolarz and Nancy G. Murphy and Janet A. Curran and Neil J. MacKinnon and Doug Sinclair},
  title = {Medication-related emergency department visits in pediatrics: a prospective observational study.},
  abstract = {<p><b>BACKGROUND AND OBJECTIVE: </b>There are few data on the rate and characterization of medication-related visits (MRVs) to the emergency department (ED) in pediatric patients. We sought to evaluate the frequency, severity, preventability, and classification of MRVs to the ED in pediatric patients.</p><p><b>METHODS: </b>We performed a prospective observational study of pediatric patients presenting to the ED over a 12-month period. A medication-related ED visit was identified by using pharmacist assessment, emergency physician assessment, and an independent adjudication committee.</p><p><b>RESULTS: </b>In this study, 2028 patients were enrolled (mean age, 6.1 ± 5.0 years; girls, 47.4%). An MRV was found in 163 patients (8.0%; 95% confidence interval [CI]: 7.0%-9.3%) of which 106 (65.0%; 95% CI: 57.2%-72.3%) were deemed preventable. Severity was classified as mild in 14 cases (8.6%; 95% CI: 4.8%-14.0%), moderate in 140 cases (85.9%; 95% CI: 79.6%-90.8%), and severe in 9 cases (5.5%; 95% CI: 2.6%-10.2%). The most common events were related to adverse drug reactions 26.4% (95% CI: 19.8%-33.8%), subtherapeutic dosage 19.0% (95% CI: 13.3%-25.9%), and nonadherence 17.2% (95% CI: 11.7%-23.9%). The probability of hospital admission was significantly higher among patients with an MRV compared with those without an MRV (odds ratio, 6.5; 95% CI: 4.3-9.6) and, if admitted, the median (interquartile range) length of stay was longer (3.0 [5.0] days vs 1.5 [2.5] days, P = .02).</p><p><b>CONCLUSIONS: </b>A medication-related cause was found in ∼1 of every 12 ED visits by pediatric patients, of which two-thirds were deemed preventable. Pediatric patients who present to the ED with an MRV are more likely to be admitted to hospital and when admitted have a longer length of stay.</p>},
  year = {2015},
  journal = {Pediatrics},
  volume = {135},
  pages = {435-43},
  month = {03/2015},
  issn = {1098-4275},
  doi = {10.1542/peds.2014-1827},
  language = {eng},
}