At the same time, although most (82.8%) patients did not receive treatment in a healthcare facility, 2.3% were admitted and 4.2% had a serious medical outcome, according to an article in the journal Pediatrics.
The researchers from The Abigail Wexner Research Institute at Nationwide Children’s Hospital in Columbus, Ohio, and colleagues sought to investigate the characteristics and trends of out-of-hospital ADHD medication-related therapeutic errors among youth aged younger than 20 years and reported to U.S. poison centers.
The study team analyzed information from the National Poison Data System data from 2000 through 2021, finding that there were 124,383 ADHD medication-related therapeutic errors reported from 2000 through 2021, with the annual frequency increasing by 299.0% during that period.
Their analysis reveals that two-thirds (66.6%) of the 87,691 first-ranked exposures involved children aged 6 to 12 years, three-fourths (76.4%) were males, and one-half (50.5%) involved amphetamines and related compounds. Most (79.7%) therapeutic errors were single-substance exposures.
“Children <6 years old were more likely to experience a serious medical outcome (odds ratio = 2.1; 95% CI: 1.9-2.3) or be admitted to an HCF (odds ratio = 3.4; 95% CI: 3.0-3.7) than 6 to 19-year-olds,” the authors wrote. “The most common scenarios were “inadvertently taken or given medication twice” (53.9%), followed by “inadvertently taken or given someone else’s medication” (13.4%), and “wrong medication taken or given” (12.9%).
The researchers pointed out that the frequency of cases reported to poison centers of pediatric out-of-hospital therapeutic errors related to ADHD medications increased by almost 300% during the 22-year study period and “is likely attributable to increased prescribing of these medications. Because therapeutic errors are preventable, more attention should be given to patient and caregiver education and development of improved child-resistant medication dispensing and tracking systems.”
Background information in the articles noted that ADHD is among the most common pediatric neurodevelopmental disorders. In 2019, an estimated 9.4% of U.S. children had a diagnosis of ADHD, and approximately 3.3 million children were prescribed medication for the condition.
The study pointed out that a range of pharmacotherapies are approved for ADHD, with the most common being stimulants, such as methylphenidate, amphetamine, lisdexamfetamine, and modafinil. Approved nonstimulant drugs include atomoxetine, guanfacine, and clonidine. The authors advised that in 2013, U.S. healthcare expenditures for ADHD were estimated to range between $38 billion and $72 billion.
Of that amount, $24 million was spent on hospital admissions attributed to unintentional ADHD medication exposures, including therapeutic errors.
“Research specifically investigating pediatric ADHD medication exposures has not focused on therapeutic errors,” the researchers wrote. “In addition, the most recent study to analyze trends in ADHD medication exposures only includes data through 2014. The objective of this study is to investigate the characteristics and trends of out-of-hospital ADHD medication errors among youth <20 years old reported to US poison centers (PCs) from 2000 through 2021.”
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