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Characteristics of medication errors in pediatrics
A P Jonville1, E Autret, F Bavoux
1Department of Pharmaco-Toxicovigilance, Hôpital Bretonneau, Tours, France.
Insights
Medication errors in children are common, often involving family members and oral medications. Improving pediatric formulations and patient education can help prevent these errors.
Area of Science:
- Pediatric pharmacology
- Medication safety
- Public health
Background:
- Medication errors pose a significant risk in pediatric populations.
- Understanding the epidemiology of these errors is crucial for prevention.
Purpose of the Study:
- To assess the epidemiology of medication errors in pediatric patients.
- To identify common characteristics and contributing factors of these errors.
Main Methods:
- A prospective study conducted across 16 poison control centers in France.
- Analysis of 1108 reported medication errors in children aged 3 days to 15 years.
Main Results:
- Family members were involved in 87% of errors; parental decisions and incorrect execution were also frequent.
- Oral formulations accounted for 52% of errors, with incorrect dosage and drug errors occurring in approximately 30% each.
- Iatrogenic injury occurred in 17% of cases, leading to hospitalization in 15%, primarily for observation.
Conclusions:
- Medication errors in children are a substantial issue, frequently involving family administration and oral dosage forms.
- Key prevention strategies include pediatric-specific formulations, enhanced patient/parental education by healthcare professionals, and increased public awareness of medication risks.
Abstract:
A six-month prospective study was carried out by 16 poison control centers in France to assess the epidemiology of medication errors in pediatrics. In this study, 1108 medication errors were analyzed. Mean population age was 3.2 years (median 2 years, range 3 days-15 years), and 30 percent of the children were under 1 year of age. The most frequent error characteristics were family responsibility, 87 percent (a member of the patient's family most often committed the error in medication use); parental prescribing decision, 31.5 percent (medication administered to the child by the parents without medical consultation or the advice of a pharmacist); incorrect execution of the prescription by the parents, 30 percent (error in dispensing, route of administration, etc.); oral forms, 52 percent (errors occurred most frequently with oral as opposed to other forms); incorrect dosage, 31.5 percent; and drug error, 30 percent (the drug dispensed was not the one prescribed). Iatrogenic injury occurred in 186 patients (17 percent) and 161 were hospitalized (15 percent). The majority of these were for surveillance only. The clinical outcome caused by medication error was unfavorable in two cases. The types of drugs most frequently misused included morphinic cough suppressants (9.5 percent), salicylates (9.1 percent), and ear, nose, and throat drops (9 percent); 459 proprietary medicines were specified. Prevention of medication errors should involve certain main requirements: formulations and package instructions specific to pediatric patients to ensure appropriateness and accuracy, detailed information given to patients by physicians and pharmacists about their prescriptions, and more public information concerning the risks of remedies or medication administered to children by parents who do not seek medical advice.