The Reason Many Kids Visit the ER

Adverse medication events may be behind many child emergency room visits

(RxWiki News) An often preventable but common problem may be the reason many kids visit the emergency room.

A new study found that, like adults, many children visit the ER due to medication-related issues. The majority of these visits could be prevented, the authors of this study said.

Many adults visit the ER or are admitted to the hospital for medication-related issues. Few studies, however, have focused on the rates and impact of medication-related ER visits in children.

Peter J. Zed, PharmD, of the University of British Columbia in Vancouver, Canada, led this study.

"Clearly the rate of events is an important finding with many clinical implications both in primary care and to practitioners in the ER," Dr. Zed told dailyRx News. "Equally important is the finding that [many] of these events are preventable, which presents an important opportunity to explore better strategies to prevent these events before these patients ever present to the ER."

David Winter, MD, a board-certified internist and president of HealthTexas Provider Network, a division of the Baylor Health Care System, told dailyRx News that parents should also play a role in preventing medication-related problems in children.

"Adverse drug events in children are a significant cause of visits to emergency departments," Dr. Winter said. "Parents need to take an active role in the supervision of medications prescribed to children, and to any medications to which a child might access."

Dr. Zed and team enrolled more than 2,000 children who visited the ER of one health care center over a one-year period. The children were around 6 years old on average.

These researchers interviewed each patient and his or her family to assess the reason for the ER visit, as well as medical history and any medications taken.

Of the patients studied, 8 percent were found to have visited the ER for a medication-related issue. A visit was considered a medication-related visit (MRV) if the main reason for the visit was linked to a medication the patient took.

Around 26 percent of these MRVs were tied to adverse reactions to medications. An adverse reaction is any unintended or harmful response to a medication. Taking smaller doses than prescribed (19 percent) or not adhering to the medication's regimen (17.2 percent) were also common reasons for MRVs.

Patients with an MRV had higher odds of being admitted to the hospital than patients without an MRV. Also, patients with an MRV tended to stay longer (three days) when admitted, compared to those without an MRV (1.5 days).

Dr. Zed and team estimated that 65 percent of these MRVs could have been prevented.

These researchers said future research should focus on strategies to prevent MRVs by improving prescribing practices and monitoring those patients at greater risk.

"Clinicians should be more aware of the potential for adverse events in pediatrics, and when possible implement strategies which can minimize or prevent these events," Dr. Zed said.

This study was published online Feb. 2 in Pediatrics.

A Health Project grant from the Nova Scotia Health Research Foundation funded this research. The authors disclosed no conflicts of interest.

Review Date: 
January 28, 2015