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Emergency hospitalizations for unsupervised prescription medication ingestions by young children
Maribeth C Lovegrove1, Justin Mathew2, Christian Hampp2
1Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia; mlovegrove@cdc.gov.
Insights
Unsupervised prescription medication ingestions by young children lead to thousands of emergency hospitalizations annually. Buprenorphine products show a significantly higher hospitalization rate, indicating a critical target for prevention efforts.
Area of Science:
- Pediatric Emergency Medicine
- Public Health Surveillance
- Pharmacovigilance
Background:
- Childhood unsupervised prescription medication ingestions are a growing public health concern, leading to increased emergency department visits and hospitalizations.
- Despite safety measures and education, the incidence of these ingestions remains high, necessitating better identification of high-risk medications.
- Limited data on specific implicated medications hinder targeted prevention strategies.
Purpose of the Study:
- To estimate the frequency and rates of emergency hospitalizations for unsupervised prescription medication ingestions in young children in the U.S.
- To identify the specific medication classes and active ingredients most frequently associated with these ingestions and hospitalizations.
- To inform public health efforts by highlighting medications with disproportionately high hospitalization rates.
Main Methods:
- Utilized nationally representative data from the National Electronic Injury Surveillance System-Cooperative Adverse Drug Event Surveillance (NEISS-CADES) project (2007-2011).
- Integrated national retail pharmacy prescription data from IMS Health to calculate hospitalization rates per unique patient.
- Analyzed emergency hospitalizations for unsupervised prescription medication ingestions among children under 6 years old.
Main Results:
- An estimated 9,490 annual emergency hospitalizations occurred for unsupervised prescription medication ingestions in children under 6 (2007-2011), with 75.4% involving 1- and 2-year-olds.
- Opioids and benzodiazepines were the most common classes, with buprenorphine (7.7%) and clonidine (7.4%) as leading active ingredients.
- Buprenorphine products exhibited a hospitalization rate 97-fold higher than oxycodone products per 100,000 unique patients, indicating a critical safety concern.
Conclusions:
- Targeting prevention efforts toward medications with the highest unsupervised ingestion hospitalization rates can yield significant public health benefits.
- Buprenorphine and clonidine are key targets for enhanced prevention strategies due to their high association with pediatric hospitalizations.
- Further research and targeted interventions are crucial to reduce the burden of unsupervised prescription medication ingestions in young children.
Background:
Emergency department visits and subsequent hospitalizations of young children after unsupervised ingestions of prescription medications are increasing despite widespread use of child-resistant packaging and caregiver education efforts. Data on the medications implicated in ingestions are limited but could help identify prevention priorities and intervention strategies.
Methods:
We used nationally representative adverse drug event data from the National Electronic Injury Surveillance System-Cooperative Adverse Drug Event Surveillance project and national retail pharmacy prescription data from IMS Health to estimate the frequency and rates of emergency hospitalizations for unsupervised prescription medication ingestions by young children (2007-2011).
Results:
On the basis of 1513 surveillance cases, 9490 estimated emergency hospitalizations (95% confidence interval: 6420-12,560) occurred annually in the United States for unsupervised prescription medication ingestions among children aged <6 years from 2007 through 2011; 75.4% involved 1- or 2-year old children. Opioids (17.6%) and benzodiazepines (10.1%) were the most commonly implicated medication classes. The most commonly implicated active ingredients were buprenorphine (7.7%) and clonidine (7.4%). The top 12 active ingredients, alone or in combination with others, were implicated in nearly half (45.0%) of hospitalizations. Accounting for the number of unique patients who received dispensed prescriptions, the hospitalization rate for unsupervised ingestion of buprenorphine products was significantly higher than rates for all other commonly implicated medications and 97-fold higher than the rate for oxycodone products (200.1 vs 2.1 hospitalizations per 100,000 unique patients).
Conclusions:
Focusing unsupervised ingestion prevention efforts on medications with the highest hospitalization rates may efficiently achieve large public health impact.
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