Out-of-hospital medication error rate unchanged in young children

1. Between 2002 and 2012, the rate of out-of-hospital medication errors in children under age 6 did not change, despite a significant decrease in the number of errors involving cough and cold preparations.

2. The number of out-of-hospital medication errors in children under 6 was inversely correlated with age, with children less than age 1 accounting for 25% of all medication errors.

Evidence Rating Level: 2 (Good) 

Study Rundown: Out-of-hospital medication errors are a frequent cause for poison control center reports in young children. This study examined trends in out-of-hospital medication errors reported to poison control centers in children under 6 during a 10-year period. Results indicated that despite a significant decrease in the number of errors related to cough and cold medications, the increased rate of other medication errors kept the overall rate of medication errors unchanged. The number of cases was inversely correlated with age and children less than 1 year old accounted for 25% of all medication errors. Findings also show that more than 90% of reported cases did not require medical attention at a healthcare facility. The study is limited by its use of only cases reported to poison control centers, so both unreported and unrecognized errors were not included. However, the large, representative sample suggests that the previous increased efforts surrounding cough and cold medication errors in the early 2000s may be effective in reducing other medication errors.

Click to read the study, published today in Pediatrics

Relevant Reading: Effect of cough and cold medication restriction and label changes on pediatric ingestions reported to United States poison centers

In-depth [retrospective cohort study]: This study examined 696 937 out-of-hospital medication error exposures in children less than age 6 between 2005 and 2012. Data were obtained from the National Poison Data System, which includes information from each of the regional poison control centers in the United States. During the study period, the number and rate of errors related to cough and cold medications fell by 66.1% (p<0.001) and 66.6% (p<0.001), respectively. However, the number and rate of non-cough and cold medication errors climbed by 42.9% (p<0.001) and 37.2% (p<0.001), respectively, with most of this increase being attributed to analgesics and antihistamines. Analgesic errors were most commonly reported, accounting for 25.2% of cases overall during the 10-year study period. Cough and cold preparations (24.6%), antihistamines (15.0%), antimicrobials (11.8%), and gastrointestinal preparations (4.2%) were the next most commonly reported medication errors. The number and rate of medication errors were negatively correlated with age (r=-0.994, p<0.001 and r=-0.994, p<0.001, respectively), with children under age 1 accounting for 25.2% of cases and children over age 5 accounting for 9.7% of cases.

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