Risk factors in preventable adverse drug events in pediatric outpatients.
OBJECTIVE
To determine whether there are racial/ethnic, socioeconomic, parental linguistic, or parental educational disparities in children who experienced an adverse drug event (ADE) in the ambulatory setting.


METHODS
We conducted a prospective cohort study of pediatric patients <21 years seen during 2-month study periods from July 2002 to April 2003 at 6 office practices in Boston. The primary outcome measure was ADEs. Descriptive analysis of patient characteristics and types of ADEs experienced was followed by multivariate analysis to determine risk factors associated with presence of a preventable ADE.


RESULTS
A total of 1689 patients receiving 2155 prescriptions were analyzed via a survey and chart review. Overall, 242 children (14%) experienced an ADE, of which 55 (23%) had a preventable ADE and 186 (77%) had a non-preventable ADE. In multivariate analysis, children with multiple prescriptions (odds ratio, 1.46; 95% CI, 1.01-2.11) were at increased risk of having a preventable ADE, controlling for parental education, racial/ethnic, English proficiency, practice type, and duration of care.


CONCLUSIONS
Children with multiple prescriptions are at increased risk of having a preventable ADE. Further attention should be directed toward improved communication among healthcare providers and patients.
Zandieh
Stephanie O
SO
Department of Pediatrics, Weill Cornell Medical College and Komansky Center for Children's Health at New York Presbyterian Hospital, New York, New York, USA.
Goldmann
Donald A
DA
Keohane
Carol A
CA
Yoon
Catherine
C
Bates
David W
DW
Kaushal
Rainu
R
D000293:Adolescent; D016907:Adverse Drug Reaction Reporting Systems; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D011307:Drug Prescriptions; D005260:Female; D006760:Hospitalization; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008508:Medication Errors / Q000517:prevention & control*; D015999:Multivariate Analysis; D016017:Odds Ratio; D010372:Pediatrics / Q000379:methods*; D011446:Prospective Studies; D012307:Risk Factors; D016896:Treatment Outcome