Trends in Emergency Department Visits for Unsupervised Pediatric Medication Exposures, 2004-2013.
BACKGROUND
After 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 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 through 2013, the dosage form and prescription status of implicated medications were identified.


RESULTS
Based on 13,268 cases, there were an estimated 640,161 ED visits (95% confidence interval: 512,885 to 767,436) for unsupervised medication exposures from 2004 through 2013. From 2004 through 2010, ED visits for unsupervised exposures increased by an average of 5.7% annually, peaking at 75,842. After 2010, this trend reversed, and visits decreased by an average of 6.7% annually to 59,092 in 2013. From 2010 through 2013, 91.0% of unsupervised exposure visits 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%). More than 260 different prescription solids were implicated; opioids (13.8%) and benzodiazepines (12.7%) were the most common 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.
Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia; mlovegrove@cdc.gov.
Maribeth C
MC
Lovegrove
Chenega Government Consulting, Atlanta Georgia.
Nina J
NJ
Weidle
Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia;
Daniel S
DS
Budnitz
D000293:Adolescent; D016907:Adverse Drug Reaction Reporting Systems; D002648:Child; D002675:Child, Preschool; D004636:Emergency Service, Hospital / Q000639:trends*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D010372:Pediatrics; D063487:Prescription Drug Misuse / Q000706:statistics & numerical data*; D019966:Substance-Related Disorders / Q000453:epidemiology*; D014481:United States