Medication-Related Emergency Department Visits and Hospital Admissions in Pediatric Patients: A Qualitative Systematic Review

Zed, Peter J.; Haughn, Christopher; Black, Karen; Fitzpatrick, Eleanor; Ackroyd‐Stolarz, Stacy; Murphy, Nancy G.; MacKinnon, Neil J.; Curran, Janet; Sinclair, Douglas

doi:10.1016/j.jpeds.2013.01.042

Cited by 44 publications

(39 citation statements)

References 57 publications

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“…30 It is possible that because adverse drug-related events often require time and monitored observation for treatment or resolution, hospital admission is more frequently indicated. Specific risk factors for MRVs are inconsistently identified in the literature 56 ; however, we were able to identify age, CTAS, and the number of comorbidities as predictors of MRVs. These 3 factors would suggest that as patients get older and experience more comorbidities, it would result in a greater likelihood of medication exposure and as a result would predict a greater chance of experiencing an ADE, which would result in an ED visit.…”

Section: Discussionmentioning

confidence: 67%

“…16,[45][46][47][48][49][50][51][52][53][54][55] Retrospective evaluation, often conducted by using medical record review or use of administrative databases, has inherent limitation for reporting bias, challenges with event ascertainment, as well as causality and preventability assessment, and has reported much lower event rates compared with prospective studies. 11,56 Finally, no study has prospectively explored this issue in Canada, so the impact in our own country remains uncertain. The incidence and classifications of medication-related ADEs in pediatrics cannot be expected to be the same as adults due in large part to the agerelated prevalence of disease, as well as the spectrum and scope of medication use.…”

Section: What This Study Addsmentioning

confidence: 99%

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Medication-Related Emergency Department Visits in Pediatrics: a Prospective Observational Study

et al. 2015

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Section: Discussionmentioning

confidence: 67%

Section: What This Study Addsmentioning

confidence: 99%

Medication-Related Emergency Department Visits in Pediatrics: a Prospective Observational Study

et al. 2015

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“…Although the true extent of medication errors in the outpatient setting have not been clearly described, recent studies in general pediatrics and specific chronic diseases in children indicate a high rate of medication errors [15,16,17]. Unfortunately, some of these errors have caused deleterious consequences leading to emergency department visits and hospitalizations.…”

Section: Necessity Of Medication Therapy Management In Pediatric Pmentioning

confidence: 99%

“…A study evaluated the rate of medication errors in pediatric patients with cancer during home administration of chemotherapy [17]. In the study, the investigators conducted medication reviews to detect discrepancies between the prescribed and administered regimens.…”

Section: Necessity Of Medication Therapy Management In Pediatric Pmentioning

confidence: 99%

Establishment of Pediatric Medication Therapy Management: A Proposed Model

et al. 2016

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Ongoing healthcare reform calls for increased accessibility, enhanced delivery, and improved quality of healthcare. Children and adolescents are experiencing a rise in the prevalence in chronic diseases leading to an increased utilization of medications. The increased use of chronic medications can lead to more medication errors or adverse drug events, particularly in children and adolescents using multiple chronic medications. These ongoing changes expand opportunities for a pharmacist to become further integrated in the inter-professional healthcare delivery for pediatric patients, particularly in an ambulatory or community setting. To date, a systemic process for the provision of medication therapy management (MTM) services in pediatric patients has not been elucidated. The purpose of this paper is to describe a proposed model for delivering pediatric MTM. Furthermore, based on the available literature related to pediatric patients at risk for medication errors, adverse drug reactions, and subsequently-increased utilization of emergency departments and hospitalizations, a set of criteria is proposed for further research investigation.

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“…In paediatric patients, medication-related incidents accounted for 0.5–3.3 % of emergency visits and 0.16–4.3 % of hospital admissions; 20.3–66.7 % of these were estimated to be preventable [1]. Beyond the everyday problems of mistaking the names of closely related drugs (i.e.…”

Section: Introductionmentioning

confidence: 99%

Confusion between Two Amphotericin B Formulations Leading to a Paediatric Rehospitalisation

Fleury¹,

Fonzo-Christe²,

Normand³

et al. 2016

Drug Saf - Case Rep

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A heavily immunosuppressed, 43-kg, 9-year-old patient was recovering from a bone marrow transplant. Primary prophylaxis against invasive fungal infections was liposomal amphotericin B (AmBisome®, 2.3 mg/kg [100 mg] two times per week). Once home, following a first amphotericin B infusion, he presented with strong diarrhoea and vomiting; this was repeated after the second infusion. The clinical situation worsened rapidly and the patient was rehospitalised. On admission, he presented with acute renal failure. During the 2-week hospitalisation, renal function recovered progressively. A few days after returning home, a new administration of amphotericin B was again followed by diarrhoea and vomiting, together with shivering and fever. The child was again rapidly rehospitalised. Investigation revealed that the community pharmacist, relying on drug software, had selected an inappropriate substitute drug: the patient had been administered amphotericin B deoxycholate (Fungizone®) and not liposomal amphotericin B. Depending on the indication, intravenous AmBisome® is usually administered at a dose between 3 and 5 mg/kg bodyweight; this dose can be increased to up to 10 mg/kg/day. Intravenous Fungizone®, however, should be administered using an initial dose of 0.25 mg/kg bodyweight, up to a recommended 1-mg/kg/day dose. The child had thus received 100 mg of Fungizone®, or ten times the recommended dose.

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Medication-Related Emergency Department Visits and Hospital Admissions in Pediatric Patients: A Qualitative Systematic Review

Cited by 44 publications

References 57 publications

Medication-Related Emergency Department Visits in Pediatrics: a Prospective Observational Study

Medication-Related Emergency Department Visits in Pediatrics: a Prospective Observational Study

Establishment of Pediatric Medication Therapy Management: A Proposed Model

Confusion between Two Amphotericin B Formulations Leading to a Paediatric Rehospitalisation

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