Opioid Prescribing and Potential Overdose Errors Among Children 0 to 36 Months Old

Clin Pediatr (Phila). 2015 Jul;54(8):738-44. doi: 10.1177/0009922815586050. Epub 2015 May 13.

Abstract

Objective: To estimate the frequency of potential overdoses among outpatient opioid-containing prescriptions.

Method: Using 11 years of outpatient Medicaid prescription data, we compared opioid dose dispensed (observed) versus expected dose to estimate overdose error frequencies. A potential overdose was defined as any preparation dispensed that was >110% of expected based on imputed, 97th percentile weights.

Results: There were 59 536 study drug prescriptions to children 0 to 36 months old. Overall, 2.7% of the prescriptions contained potential overdose quantities, and the average excess amount dispensed was 48% above expected. Younger ages were associated with higher frequencies of potential overdose. For example, 8.9% of opioid prescriptions among infants 0 to 2 months contained potential overdose quantities, compared with 5.7% among infants 3 to 5 months old, 3.6% among infants 6 to 11 months old, and 2.3% among children >12 months (P < .0001).

Conclusions: Opioid prescriptions for infants and children routinely contained potential overdose quantities.

Keywords: child; children; medication errors; overdose; patient safety.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Analgesics, Opioid / poisoning*
  • Child, Preschool
  • Drug Overdose / epidemiology*
  • Drug Prescriptions / statistics & numerical data*
  • Female
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Medicaid
  • Medication Errors / statistics & numerical data*
  • Outpatients / statistics & numerical data
  • Retrospective Studies
  • South Carolina / epidemiology
  • United States

Substances

  • Analgesics, Opioid