Medication Safe - Dr. Ben Tsutaoka

Article published in:

Health Promotion Practice

2006 Oct;7(4):388-95. Epub 2006 Aug 21

http://hpp.sagepub.com/cgi/reprint/7/4/388

McDonald EM, Solomon BS, Shields WC, Serwint JR, Wang MC, Gielen AC.

Department of Health, Behavior and Society, Center for Injury Research and Policy at the Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.

OBJECTIVE: To assess childhood injury risk and parents’ injury interests, and the association between the two.

METHOD: A cross-sectional computer and telephone survey was conducted as part of a randomized controlled trial. The authors enrolled parents of children being seen at an urban pediatric primary care practice and measured selected injury knowledge, beliefs and safety practices. Parents were asked to select two of four topics of interest and recommendations regarding them were included in a computer-tailored report.

RESULTS: Participants (N = 105) were assessed as being at risk for all four areas: poisoning (88%), fires (85%), falls (55%), and car crashes (18%). Parents were interested in poisoning (81%) and car crashes (49%); their interests were unrelated to child’s assessed risk.

CONCLUSION: Soliciting parents’ interests prior to counseling may help to identify priority areas for counseling as well as dispel myths and unfounded fears regarding childhood injury risks.

Article published in:

The Journal of the American Osteopathic Association

2006 Jul;106(7):405-11

http://www.jaoa.org/cgi/content/full/106/7/405

McFee RB, Caraccio TR.

Long Island Regional Poison and Drug Information Center, Winthrop University Hospital, 259 First Street, Mineola, NY 11501-3957, USA. rbmcfee@pol.net

Context: Although the circumstances are not well studied, grandparents’ medications account for 10% to 20% of unintentional pediatric intoxications in the United States.

Objectives: To characterize circumstances leading to and outcomes from pediatric pharmaceutical exposures. To identify preventable risk factors associated with this pattern of injury, referred to as the “granny syndrome.”

Design, Setting, and Participants: Retrospective review of records of telephone calls made to a certified regional poison control center in the United States. Records were analyzed for all calls concerning children aged 6 years or younger who were exposed to grandparents’ medication(s). For statistical analysis, regression and chi square analysis as well as Fisher exact tests were used. The sample size provided 80% power to detect a 10% difference at the 5% level of significance. Statistical significance was set at P<.05.

Main Outcomes Measured: Use of child-resistant containers (CRCs), the location of pharmaceuticals prior to pediatric ingestion, and drug classes involved (eg, analgesics, cardiovascular drugs).

Results: Of the 200 incidents analyzed, 90 (45%) cases involved CRCs, and 110 (55%) involved containers that were not child resistant. For these incidents, the average age of the child was 18.8 months; the grandparent was aged on average 58.7 years. Most medications had been placed on tables or countertops (91 [46%]), low shelves (57 [29%]), or in pocketbooks (34 [17%]). The type of container in which the pharmacologic agent was stored (CRC vs non-CRC) was not statistically significant (P>.1). Ease of access to medication, regardless of the type of container used, was the only statistically significant outcome (P<.001). In the present study, accidental pediatric exposures most frequently involved cardiovascular (90 [45%]), analgesic (84 [42%]), and psychotropic (32 [16%]) medications.

Conclusion: Pediatric exposure to pharmaceutical agents is a preventable cause of injury. Physicians have an important opportunity to assist in preventing pediatric pharmaceutical exposures by instructing parents and grandparents on how to better limit children’s access to medications as an essential component to enhance child safety.