Program Focus and Activities
Adverse Drug Event Monitoring
There are many ways to measure the size of the problem of medication safety. Recent work at CDC has focused on the short-term, severe harm that results from medicines taken by people outside of hospital settings. It is estimated that more than 700,000 individuals are seen in hospital emergency departments for adverse drug events each year in the United States. Nearly 120,000 of these patients need to be hospitalized for further treatment. This is an important patient safety problem, but many of these adverse drug events are preventable.
Adverse Drug Events in Children
An estimated 71,000 children (18 years old or younger) are seen in emergency departments each year because of unintentional medication poisonings (excluding recreational drug use). Most of these visits (over 80%) were because an unsupervised child found and consumed the medication without adult supervision. Children less than 5 years old are twice as likely as older children to be taken to the emergency department for an adverse drug event, and one out of every 180 two-year-olds visits an emergency department for a medication poisoning annually.
Related Facts Sheets from CDC
Adverse Drug Events in Older Adults
Older adults (65 years or older) are also twice as likely as others to come to emergency departments for adverse drug events (over 177,000 emergency visits each year). Older adults are nearly seven times more likely to be hospitalized after an emergency visit, but most of these hospitalizations are due to just a few drugs known to require careful monitoring to prevent problems. Common drugs that can require monitoring are blood thinners (e.g., warfarin
), diabetes medications (e.g., insulin), seizure medications (e.g., phenytoin), and digoxin (a heart medicine).
), diabetes medications (e.g., insulin), seizure medications (e.g., phenytoin), and digoxin (a heart medicine).Adverse Drug Events from Select Medication Classes
Adverse Drug Events from Antibiotics
Antibiotics are one of the top medication classes resulting in emergency department visits for adverse drug events. There are over 140,000 emergency department visits for reactions to antibiotics each year.
- Overall, antibiotics are responsible for almost one out of five (19%) emergency department visits for adverse drug events
- In children (18 years old or younger), antibiotics are the most common cause of emergency department visits for adverse drug events
- Almost four out of five (79%) emergency department visits for antibiotic-associated adverse drug events are due to allergic reactions
Antibiotics are one of the most prescribed medication classes in the United States, which contributes to the high number of emergency department visits for adverse drug events from these medications. But, even after accounting for how often antibiotics are prescribed, the risk of an ED visit for antibiotic-associated adverse drug events is substantial. There is approximately one in 1000 risk that an individual prescribed an antibiotic will require a visit to the emergency department because of an antibiotic side effect but only one in 4000 chance that an antibiotic will prevent a serious complication from an upper respiratory infection. Because most antibiotic-associated adverse drug events are due to allergic reactions, minimizing unnecessary antibiotic use will be the best way to reduce the risk of adverse drug events from antibiotics.
Adverse Drug Events from Opioid Analgesics
In the United States, the use of opioid (narcotic) analgesics (pain-relievers) as part of pain management regimens has contributed to a poisoning epidemic. Between 1999-2002, poisonings from opioid analgesics surpassed poisonings from cocaine and heroin as the most frequent type of drug poisoning on death certificates. The increase in drug poisoning coincides with an increase in the prescription of major types of opioid analgesics, as physicians were encouraged to prescribe stronger analgesics (i.e., opioids) for pain management. When sales of opioid analgesics increased, the occurrences of opioid analgesics on death certificates increased at a similar rate. The overall goal should be to identify ways to reduce deaths from opioid analgesics without diminishing the quality of care for patients with a legitimate need for pain management.
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