Medication Errors Occur Every 8 Minutes in U.S. Children

Medication Errors Occur Every 8 Minutes in U.S. Children

Medication Errors Occur Every 8 Minutes in U.S. Children

Study finds that liquid drugs are the most commonly misused at home

SOURCES: Huiyun Xiang, M.D., M.P.H., Ph.D., professor of medicine, The Ohio State University College of Medicine, director of the Center for Pediatric Trauma Research at Nationwide Children's Hospital, and director for International Programs at Center for Injury Research and Policy at The Research Institute at Nationwide Children's Hospital; Minu George, M.D., Interim Chief, Division of General Pediatrics, Cohen Children's Medical Center, New Hyde Park, N.Y.; Nov. 2014 Pediatrics

MONDAY, Oct. 20, 2014 (HealthDay News) -- A child receives the wrong medication or the wrong dosage every eight minutes in the United States, according to a recent study.

Nearly 700,000 children under 6 years old experienced an out-of-hospital medication error between 2002 and 2012. Out of those episodes, one out of four children was under a year old. As the age of children decreased, the likelihood of an error increased, the study found.

Though 94 percent of the mistakes didn't require medical treatment, the errors led to 25 deaths and about 1,900 critical care admissions, according to the study.

"Even the most conscientious parents make errors," said lead author Dr. Huiyun Xiang, director of the Center for Pediatric Trauma Research at Nationwide Children's Hospital in Columbus, Ohio.

That conscientiousness may even lead to one of the most common errors: Just over a quarter of these mistakes involved a child receiving the prescribed dosage twice.

"One caregiver may give a child a dose, and then a second caregiver, who does not know that and wants to make sure the child gets the proper amount of medicine, may give the child a dose, too," Xiang said. Other reasons for errors included incorrectly measuring the dosage or overprescription of some medications, he said.

Xiang and his colleagues analyzed all the medication errors reported to the National Poison Data System for all children under 6 years old during the study period. Their findings were released online on Oct. 20 in the journal Pediatrics.

Another common feature was that eight of every 10 errors involved liquid medication. There are several possible reasons for that, Xiang said.

"Young children are more likely to be given liquid medicine than medicine in other forms, like tablets or capsules," he said, especially since many prescription and over-the-counter children's medications are in liquid form.

"A second reason is that liquids can be difficult to measure correctly," Xiang said. "Some liquid medications are measured in milliliters, other in teaspoons, some with measuring cups, some with syringes. That can be confusing to parents and caregivers."

A different study -- from the August issue of Pediatrics -- found that using teaspoons or tablespoons to administer children's medications was behind many drug dosing errors. Instructions requiring teaspoons or tablespoons made it twice as likely that parents or another caregiver would incorrectly follow the doctor's prescription than if the instructions were in milliliters, that study found. An error was even more likely if parents used a kitchen spoon to measure out the dose, according to the earlier study.

In the current study, Xiang's team also found that errors involving cough and cold medicines suddenly dropped by two-thirds from 2005 to 2012, a dive likely linked to two events, Xiang said.

In 2007, the U.S. Food and Drug Administration announced that it was reviewing the safety of over-the-counter cough and cold medicines for children, and soon after, manufacturers voluntarily withdrew those drugs from shelves for children under 2 years old.

Shortly thereafter, the American Academy of Pediatrics said that cough and cold medicines weren't effective in children under 6, and that those medications might pose a health risk to young children.

While errors related to those medicines dropped, however, mistakes involving other medications increased by 37 percent, though the study did not look at why.

"It may be associated with the increased use of analgesics and antihistamines among young children," said Xiang.

Pain relievers and cough and cold medicines each comprised about a quarter of all the errors identified, and antihistamines made up 15 percent of the errors. Antibiotics made up about 12 percent.

The medications causing the highest rate of hospitalization or death included muscle relaxants, cardiovascular drugs and mental health drugs, such as sedatives and antipsychotics.

To avoid these errors, Xiang recommended that parents use a smartphone app to keep to a medication schedule and to use only the measuring cup or syringe that comes with a medication for measuring it. If a mistake should occur, parents should keep the national poison emergency helpline handy: (800) 222-1222.

"Parents need to realize that medication errors at home are very common, but those errors can be reduced," he said.

One expert believes that some parents may be too ready to reach for over-the-counter medicines for their children.

"The take-home message from this study for parents is that children do not routinely require medications for fever, congestion or the common cold," said Dr. Minu George, Interim Chief of the Division of General Pediatrics at Cohen Children's Medical Center in New Hyde Park, N.Y.

"Decreasing use of the medications may lead to fewer errors," she added. "Education is key -- educating parents on how to keep their child comfortable and when it is necessary to call and/or see their physician before giving medications can prevent errors in the future."

More information

Learn more about giving medication to children from the U.S. Food and Drug Administration.

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