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Multiple prescriptions are linked to preventable drug reactions in children

Children's drugs are not as straightforward as adult medications. They come in tablets, drops, and liquids, and in many cases, the amount a parent must give depends on the child's weight. A new study finds that children who are prescribed multiple drugs at medical visits have a higher risk for experiencing preventable adverse drug events (ADEs) than children who need only one drug.

Researchers studied 1,689 children who were seen from July 2002 to April 2003 at 6 sites in Boston These children received a total of 2,155 prescriptions. Through telephone calls and chart reviews, the researchers found 283 ADEs in 242 children (14 percent). Of these events, 57 were preventable in 56 children. Seventy percent of the preventable events occurred when parents were administering medication.

The authors suggest these events likely occurred because providers did not explain to parents how to deliver the correct dosage. This can be corrected by detecting parents' health literacy and tailoring medication information to a level appropriate for them. More ADEs were discovered during chart reviews than phone interviews for children whose parents have limited English skills or were black or Hispanic.

A possible explanation is that those with limited English skills were not able to adequately explain the adverse events to a phone interviewer. On the other hand, blacks and Hispanics may be more conservative than their white counterparts in reporting the occurrence of ADEs. These groups may benefit from methods that increase awareness of how to prevent ADEs. This study was funded in part by the Agency for Healthcare Research and Quality (HS11534).

See "Risk factors in preventable adverse drug events in pediatric outpatients," by Stephanie O. Zandieh, M.D., M.S., Donald A. Goldmann, M.D., Carol A. Keohane, R.N., B.S.N., and others in the February 2008 Journal of Pediatrics 152, pp. 225-231.

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