Original articleRisk Factors in Preventable Adverse Drug Events in Pediatric Outpatients
Section snippets
Definitions
Medication errors can be categorized as errors with little potential for harm (medication errors), errors with significant potential for harm (near misses), and errors with actual harm (preventable ADE).4, 17 One example of a preventable ADE would be delay in giving a child a necessary antibiotic for a serious infection, resulting in worsening symptoms requiring a visit to the emergency department for intravenous antibiotics. This complication could have been prevented had the parents given the
Population Characteristics
During the study period, 21,209 visits were made by 13,919 patients, 3838 of whom received a prescription. Of these, we studied 1689 patients who had both completed the 10-day survey and had a chart review (Table I).
Characteristics of the study group are marked in Table II. These 1689 patients were given 2155 prescriptions, for an average of 1.3 prescriptions per patient. The number of prescriptions at the index visit ranged from 1 to 7. Children who had a chronic illness were more likely to
Discussion
Relatively little research has described the risk factors for ADEs in the pediatric outpatient setting. In this study of 6 primary care practices, we found that 14% of patients experienced an ADE, of which approximately a quarter were preventable. Children with complex medication regimens were at increased risk of having a preventable ADE. We did not find any disparities in preventable ADEs in pediatric outpatients.
As expected, children with chronic illnesses had more medications prescribed,
References (33)
Unequal treatment: report of the Institute of Medicine on racial and ethnic disparities in healthcare
Ann Thorac Surg
(2003)- et al.
The effect of limited English proficiency on admission rates from a pediatric ED: stratification by triage acuity
Am J Emerg Med
(2004) - et al.
The incidence of adverse drug events in two large academic long-term care facilities
Am J Med
(2005) - et al.
To err is human: building a safer health system
(1999) - et al.
Incidence of adverse events and negligence in hospitalized patientsResults of the Harvard Medical Practice Study I
N Engl J Med
(1991) - et al.
Medication errors and adverse drug events in pediatric inpatients
JAMA
(2001) - et al.
Limited English proficiency, primary language at home, and disparities in children’s health care: how language barriers are measured matters
Public Health Rep
(2005) - et al.
Racial and ethnic disparities in the primary care experiences of children: a review of the literature
Med Care Res Rev
(2003) - et al.
Racial and ethnic disparities in early childhood health and health care
Pediatrics
(2005) - et al.
The impact of ethnicity, family income, and parental education on children’s health and use of health services
Am J Public Health
(1999)
Racial/ethnic differences in children’s access to care
Am J Public Health
Are language barriers associated with serious medical events in hospitalized pediatric patients?
Pediatrics
Health literacy: a prescription to end confusion
Inadequate functional health literacy among patients at two public hospitals
JAMA
Low literacy impairs comprehension of prescription drug warning labels
J Gen Intern Med
Literacy and misunderstanding prescription drug labels
Ann Intern Med
Cited by (75)
Survey-based investigation into the current use of paediatric medicines and administration devices in China
2023, European Journal of Pharmaceutics and BiopharmaceuticsPediatric Nurses' Perspectives on Medication Teaching in a Children's Hospital
2017, Journal of Pediatric NursingCitation Excerpt :On an annual basis, approximately 4.3 million people in the United States (U.S.) require medical care for an adverse drug event (Bourgeois, Shannon, Valim, & Mandl, 2010). Furthermore, 70% of adverse drug events are due to errors in medication administration (Zandieh et al., 2008) and pose significant safety concerns as they often result in patient harm. In addition to risks for patient harm, adverse drug events are costly.
Accuracy of liquid drug dose measurements using different tools by caregivers: a prospective observational study
2024, European Journal of PediatricsAn mHealth Design to Promote Medication Safety in Children with Medical Complexity
2023, Applied Clinical Informatics
Supported by the Agency for Healthcare research and Quality (P01-HS11534) and the Commonwealth Fund. Dr Zandieh is the recipient of APA (Ambulatory Pediatric Association) young investigator award.