CME: Examining Medication-Related Pediatric ED Visits

CME: Examining Medication-Related Pediatric ED Visits

Physician’s Weekly talked with Peter J. Zed, BSc, BSc (Pharm), ACPR, PharmD, FCSHP, and Neil J. MacKinnon, PhD, FCSHP, about their recent study that found that about one of every 12 emergency department (ED) visits by pediatric patients is medication related.      PW: What makes medication-related pediatric ED visits an important topic to study? PZ: Adverse drug events and patient safety in healthcare have come to the forefront in the last decade. Much of the work on adverse drug events and patient safety has been conducted in adults and pediatric patients are often under-represented or excluded from this work. As a result, there are gaps in the literature surrounding the understanding of the impact of adverse drug events in pediatric patients. NM: To date, no prospective trials have been conducted in this area. In the United States, we’re trying to reduce preventable hospital readmissions, and we know that many medication-related issues are preventable. ED visits can result in hospital admission, so tackling the issue of preventable hospital admissions from the ED is important.   PW: Tell us about your recent study published in Pediatrics. What was the purpose of this research? PZ: We wanted to understand the frequency, severity, preventability, and types of adverse events that occur in pediatric patients that are significant enough to bring them to the ED. We only considered the ED visit as medication-related if it was directly related to the use or misuse of their medications. NM: The goal of our study was to determine how many ED visits in pediatric patients are medication related, and then further divide those visits into severity level and preventability. Also, we...
Examining Medication-Related Pediatric ED Visits

Examining Medication-Related Pediatric ED Visits

Physician’s Weekly talked with Peter J. Zed, BSc, BSc (Pharm), ACPR, PharmD, FCSHP, and Neil J. MacKinnon, PhD, FCSHP, about their recent study that found that about one of every 12 emergency department (ED) visits by pediatric patients is medication related.      PW: What makes medication-related pediatric ED visits an important topic to study? PZ: Adverse drug events and patient safety in healthcare have come to the forefront in the last decade. Much of the work on adverse drug events and patient safety has been conducted in adults and pediatric patients are often under-represented or excluded from this work. As a result, there are gaps in the literature surrounding the understanding of the impact of adverse drug events in pediatric patients. NM: To date, no prospective trials have been conducted in this area. In the United States, we’re trying to reduce preventable hospital readmissions, and we know that many medication-related issues are preventable. ED visits can result in hospital admission, so tackling the issue of preventable hospital admissions from the ED is important.   PW: Tell us about your recent study published in Pediatrics. What was the purpose of this research? PZ: We wanted to understand the frequency, severity, preventability, and types of adverse events that occur in pediatric patients that are significant enough to bring them to the ED. We only considered the ED visit as medication-related if it was directly related to the use or misuse of their medications. NM: The goal of our study was to determine how many ED visits in pediatric patients are medication related, and then further divide those visits into severity level and preventability. Also, we...
Outpatient bloodstream infections costly for pediatric transplant and cancer patients

Outpatient bloodstream infections costly for pediatric transplant and cancer patients

Pediatric stem cell transplant and cancer patients often are discharged from the hospital with an external central venous line for medications that parents or other caregivers must clean and flush daily to avoid potentially life-threatening infections. If an outpatient develops a bloodstream infection associated with the central line, research from Dana-Farber/Boston Children’s Cancer and Blood Disorders Center finds, the median charges to treat it total $37,000 for a hospital stay of six days for young patients whose disease treatments have weakened their immune systems and infection-fighting abilities. The results, published online by Pediatric Blood & Cancer, are part of the second phase of a collaborative effort among children’s hospitals to reduce central-line-associated bloodstream infections or CLABSIs. In the first phase, members of the Children’s Hospital Association Childhood Cancer and Blood Disorders Network reduced inpatient CLABSIs by 28 percent in less than three years, according to results published in 2014 in Pediatrics. Because a large portion of pediatric oncology and stem cell transplant patients’ care occurs in ambulatory settings, the consortium is now focusing on understanding and reducing CLABSIs that originate in the home, between outpatient clinic visits. “This issue has resonance beyond the pediatric stem cell transplant and oncology patient population,” says Amy Billett, MD, senior author of the paper and director of safety and quality at Dana-Farber/Boston Children’s. “At a time when many aspects of care are being shifted to the home and of heightened attention to safety and cost, this is the new frontier. What we learn about preventing outpatient bloodstream infections in these patients could have broad relevance.” To determine the economic and hospitalization impact of...