title: Medication-related emergency department visits and hospital admissions in pediatric patients: a qualitative systematic review.
abstract: OBJECTIVE
  To review and describe the current literature pertaining to the incidence, classification, severity, preventability, and impact of medication-related emergency department (ED) and hospital admissions in pediatric patients.
  
  
  METHODS
  A systematic search of PubMED, Embase, and Web of Science was performed using the following terms: drug toxicity, adverse drug event, medication error, emergency department, ambulatory care, and outpatient clinic. Additional articles were identified by a manual search of cited references. English language, full-reports of pediatric (≤18 years) patients that required an ED visit or hospital admission secondary to an adverse drug event (ADE) were included.
  
  
  RESULTS
  We included 11 studies that reported medication-related ED visit or hospital admission in pediatric patients. Incidence of medication-related ED visits and hospital admissions ranged from 0.5%-3.3% and 0.16%-4.3%, respectively, of which 20.3%-66.7% were deemed preventable. Among ED visits, 5.1%-22.1% of patients were admitted to hospital, with a length of stay of 24-72 hours. The majority of ADEs were deemed moderate in severity. Types of ADEs included adverse drug reactions, allergic reactions, overdose, medication use with no indication, wrong drug prescribed, and patient not receiving a drug for an indication. Common causative agents included respiratory drugs, antimicrobials, central nervous system drugs, analgesics, hormones, cardiovascular drugs, and vaccines.
  
  
  CONCLUSIONS
  Medication-related ED visits and hospital admissions are common in pediatric patients, many of which are preventable. These ADEs result in significant healthcare utilization.
authors: Faculty of Pharmaceutical Sciences, Department of Emergency Medicine, The University of British Columbia, Vancouver, British Columbia, Canada. peter.zed@ubc.ca
authors: Peter J
authors: PJ
authors: Zed
authors: Christopher
authors: C
authors: Haughn
authors: Karen J L
authors: KJ
authors: Black
authors: Eleanor A
authors: EA
authors: Fitzpatrick
authors: Stacy
authors: S
authors: Ackroyd-Stolarz
authors: Nancy G
authors: NG
authors: Murphy
authors: Neil J
authors: NJ
authors: MacKinnon
authors: Janet A
authors: JA
authors: Curran
authors: Doug
authors: D
authors: Sinclair
mesh_terms: D002648:Child; D064420:Drug-Related Side Effects and Adverse Reactions / Q000453:epidemiology*; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D006801:Humans; D008508:Medication Errors / Q000706:statistics & numerical data*; D010343:Patient Admission / Q000706:statistics & numerical data*
keywords: ADE; ADR; ADRE; Adverse drug event; Adverse drug reaction; Adverse drug-related event; CNS; Central nervous system; ED; Emergency department; ICU; Intensive care unit