Trends in Emergency Department Visits for Unsupervised Pediatric Medication Exposures, 2004–2013
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Trends in Emergency Department Visits for Unsupervised Pediatric Medication Exposures, 2004–2013

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      Background Following reports of increasing emergency department (ED) visits for unsupervised pediatric medication exposures in the 2000s, renewed efforts to improve safety packaging and education were initiated. National data on current trends and implicated medications can help further target interventions. Methods We used nationally-representative data from the National Electronic Injury Surveillance System–Cooperative Adverse Drug Event Surveillance project (2004–2013) to assess trends in ED visits for unsupervised medication exposures in children aged <6 years. For 2010–2013, we identified the dosage form and prescription status of implicated medications. Results Based on 13,268 cases, there were an estimated 640,161 ED visits (95% confidence interval: 512,885–767,436) for unsupervised medication exposures from 2004–2013. From 2004–2010, the number of ED visits for unsupervised exposures increased by an average of 5.7% annually, peaking at 75,842. After 2010, this trend reversed and ED visits decreased by an average of 6.7% annually to 59,092 estimated visits in 2013. From 2010–2013, 91.0% of ED visits for unsupervised exposures involved 1 medication, most commonly an oral prescription solid (45.9%), oral over-the-counter (OTC) solid (22.3%), or oral OTC liquid (12.4%); 9.0% of visits involved >1 medication. Over 260 different prescription solids were implicated; opioids (13.8%) and benzodiazepines (12.7%) were the most commonly implicated classes. Four medications were implicated in 91.2% of OTC liquid exposure visits: acetaminophen (32.9%), cough and cold remedies (27.5%), ibuprofen (15.7%), and diphenhydramine (15.6%). Conclusions Targeting prevention efforts based on harm frequency and intervention feasibility can lead to continued reductions in ED visits for pediatric medication exposures.
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