Safety and Preventive CareAdverse Drug Events in Pediatric Outpatients
Section snippets
Methods
We performed a prospective cohort study of patients under age 21 from 6 office practices. Data collection methodologies included duplicate prescription review, 2 surveys, and chart review. All data were reviewed for medication errors, including those with the potential for harm (near misses) and those that actually caused harm (preventable ADEs). In addition, data were reviewed for harm from medications that were not associated with an error (nonpreventable ADEs). All ADEs were further
Rates of Prescriptions and Survey Responses
During the study period, 21 209 visits were made by 13 919 patients, of whom 3838 (28%) received a prescription (Figure 1). Of these, 1007 (26%) patients were excluded. Of the remaining 2831 patients, 328 (12%) opted out of the study and 1788 (63%) completed the initial survey, with office practice response rates ranging from 58% to 78%. The second survey was completed by 1239 (69%) of these 1788 patients.
Parents most commonly were the survey respondents (1715 [96%]), followed by legal
Discussion
We found that ADEs were common in the pediatric ambulatory setting, occurring in about 16% of children treated. This result is particularly surprising given the simpler medication regimens in pediatric outpatients compared with pediatric inpatients and adult outpatients. Of the ADEs, 1 in 5 were judged to be preventable, and just over half were able to be ameliorated. Most were of relatively low severity. Of note, errors resulting in ADEs occurred most commonly at the stage of drug
Acknowledgments
We thank the 6 office practices, their pediatric health care providers, and their patients for participating in this study. This study was supported by a grant from The Agency for Health Care Research and Quality, Rockville, Md. (Grant #5 P01 HS11534-04).
References (19)
- et al.
Pediatric medication errors: what do we know? What gaps remain?
Ambul Pediatr
(2004) - et al.
Potential medication dosing errors in outpatient pediatrics
J Pediatr
(2005) - Institute of Medicine. To Err Is Human. Building a Safer Health System. Kohn LT, Corrigan JM, Donaldson MS, eds....
- et al.
Incidence of adverse events and negligence in hospitalized patients. Results of the Harvard Medical Practice Study I
N Engl J Med
(1991) - et al.
The nature of adverse events in hospitalized patients. Results of the Harvard Medical Practice Study II
N Engl J Med
(1991) - et al.
Incidence and types of adverse events and negligent care in Utah and Colorado
Med Care
(2000) - et al.
Incidence of adverse drug events and potential adverse drug events. Implications for prevention. ADE Prevention Study Group
JAMA
(1995) - et al.
Medication errors and adverse drug events in pediatric inpatients
JAMA
(2001) - et al.
Adverse drug events in ambulatory care
N Engl J Med
(2003)
Cited by (112)
Medication errors in children visiting pediatric emergency departments
2023, Farmacia HospitalariaParent satisfaction survey in a pediatric ambulatory care clinic utilizing an interprofessional education model
2023, Journal of Interprofessional Education and PracticeMaking Polypharmacy Safer for Children with Medical Complexity
2023, Journal of PediatricsCitation Excerpt :An adverse drug event is defined as “Any harm experienced by a patient as a result of exposure to a medication.” An adverse drug event can happen as a direct result of the medication itself, like oversedation by a central nervous system agent or through a drug interaction with another medication, and most commonly manifests as a dermatologic, gastrointestinal, or respiratory symptom.7,11,16 Or an adverse drug event could happen as a consequence of administration, like a mismeasured dose or improperly prepared liquid medication, which has been associated with undertreated symptoms among CMC, like seizures or pain.12
The relationship of parental health literacy to health outcomes of children with medical complexity
2021, Journal of Pediatric NursingDevelopment and stability of an oral suspension of procarbazine in pediatrics
2019, Journal of Drug Delivery Science and Technology