Category: Paediatrics

Categories : Cancer PaediatricsTags :

The Urgent Need for Early Detection Emphasised this Bone Marrow & Leukaemia Awareness Month

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Credit: National Cancer Institute

Leukaemia has been identified as the most prevalent cancer among the country’s youth, according to the latest report from the National Cancer Registry (NCR) of South Africa (2021). However, approximately half of children with cancer remain undiagnosed, with the majority of cases only being detected during the advanced stages of the illness. This is partly attributed to a lack of awareness of the early warning signs of childhood cancer.

As the world observes Bone Marrow & Leukaemia Awareness Month until the 15th of October, Dr Candice Hendricks, Paediatric Haematologist and Medical Spokesperson for DKMS Africa shares that leukaemia can be categorised as acute leukaemias or chronic leukaemias, each with varying symptoms. “Acute leukaemias are far more common in children and can further be divided into acute lymphoblastic- (ALL) and acute myeloid leukaemia (AML). Among children, especially those aged between two and 10, Acute Lymphoblastic Leukaemia (ALL) is the most common blood cancer in this age group.

“This disease arises from genetic mutations in immature lymphocytes called lymphoblasts which are located in the bone marrow. The mutations lead to uncontrolled growth of these lymphoblasts,” she explains. “Lymphoblasts are abnormal blood stem cells that lose the ability to make mature blood cells. The uncontrolled growth of these cells in the bone marrow displaces normal blood cell development and leads to a decrease in properly functioning red blood cells, white blood cells, and platelets. Patients may potentially present with an elevated white blood cell count on blood results, however, their impaired function leaves the body vulnerable to infections.”

Aligned with the NCR, Dr Hendricks emphasises that early symptoms often go unnoticed, as they mimic common, mild conditions, causing many patients and those who care for them to overlook them. “However, the severity of these symptoms escalates rapidly with acute leukaemias and persist even after standard treatment for infections. A high index of suspicion is required in diagnosing patients, and if any symptom persists, an immediate full blood count test is necessary, followed by additional tests if irregularities are detected.”

Prominent symptoms indicating the disease include:

  • Blood clotting disorders or blood diathesis characterised by easy bruising from minor impacts and the appearance of small reddish spots on the skin. Other signs encompass blood in urine, as well as uncontrollable gum and nose bleeding.
  • Muscle and joint pain, particularly in the limbs, along with frequent limb numbness.
  • Fever and night sweats.
  • Anaemia caused by a deficiency of red blood cells, leading to constant fatigue, reduced exercise capacity, lethargy, sleepiness, and pale skin.
  • Recurrent infections that persist despite antibiotic treatment due to cancer cells impairing the immune system. Pathological cancer cells displace healthy leukocytes, rendering the body susceptible to various viral, bacterial, and fungal infections.
  • Loss of appetite and weight loss.
  • Enlarged lymph nodes.
  • Stomach pain resulting from spleen and/or liver enlargement.

In support of Bone Marrow & Leukaemia Awareness Month, DKMS Africa continues to raise awareness and funds to cover the registration costs for as many potential stem cell donors as possible. Stem cell donations offer the best chance of survival for children afflicted by high-risk leukaemia which does not respond to or recurs after standard treatment. Answer the call! If you’re aged between 17 and 55 and in good general health, please register at https://www.dkms-africa.org/register-now. Registration is entirely free and takes less than five minutes.

For further information, get in touch with DKMS Africa at 0800 12 10 82.

About DKMS
DKMS is an international non-profit organisation dedicated to saving the lives of patients with blood cancer and blood disorders. Founded in Germany in 1991 by Dr. Peter Harf, DKMS and organisations of over 1,000 employees have since relentlessly pursued the aim of giving as many patients as possible a second chance at life. With over 11 million registered donors, DKMS has succeeded in doing this 100,000 times to date by providing blood stem cell donations to those in need. This accomplishment has led to DKMS becoming the global leader in the facilitation of unrelated blood stem cell transplants. The organisation has offices in Germany, the US, Poland, the UK, Chile and South Africa. In India, DKMS has founded the joint venture DKMS-BMST together with the Bangalore Medical Services Trust. International expansion and collaboration are key to helping patients worldwide because, like the organisation itself, blood cancer knows no borders.

DKMS is also heavily involved in the fields of medicine and science, with its own research unit focused on continually improving the survival and recovery rate of patients. In its high-performance laboratory, the DKMS Life Science Lab, the organisation sets worldwide standards in the typing of potential blood stem cell donors.

Categories : Paediatrics Surgeries & ProceduresTags :

Early Cleft Palate Surgery Yields Better Speech Results

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Photo by William Fortunato on Pexels

According to a new international study published in the New England Journal of Medicine, cleft palate surgery at the age of six months provides better conditions for speech and language development compared to surgery at 12 months.

Isolated cleft palate is a congenital condition where the palate is not closed and there is an opening between the mouth and the nose. The condition occurs in 1 to 25 per 10 000 births worldwide.

“There has previously been limited evidence for the optimal age for cleft palate surgery in children to achieve the best results”, says Anette Lohmander, professor emeritus at at Karolinska Institutet and principal investigator for the Stockholm centre in the study.

The study, by researchers from Karolinska Institutet and Karolinska University Hospital, among others, involved 558 children from 23 different centres around Europe and South America. Of these, 235 children were randomly assigned to a group to undergo surgery at six months of age and 226 children were randomly assigned to undergo surgery at twelve months of age.

Speech-language therapists/pathologists performed standardised audio-video recordings at one, three and five years of age. The researchers then evaluated the children’s babbling, velopharyngeal function, and speech.

At age five, the researchers found insufficient velopharyngeal function in 21 children (8.9%) who had surgery at six months of age compared with 34 children (15%) who had surgery at age 12 months.

Complications resulting from surgery were rare in both groups. Four serious adverse events were reported but were resolved on follow-up.

The conclusion of the study was that velopharyngeal function for speech at five years was better in the children who had undergone surgery at six months of age than in those who had undergone surgery at 12 months of age. Risks associated with earlier repair may include maxillary arch constriction and the need for secondary surgery for velopharyngeal insufficiency.

“An additional advantage of the early surgery age was a higher incidence of canonical syllables. It is a milestone in children’s language development and is established in typically developed children by the age of ten months at the latest,” says Anette Lohmander, who continues. “The children included in the study had no developmental delay or other deviant conditions. The conclusion is that when it is possible to operate on the cleft palate early, it seems to provide the best conditions for speech and language development.”

Source: Karolinska Institutet

Categories : Mental Health PaediatricsTags :

Is There a Risk of Manic Episodes in Children Taking Antidepressants?

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Mania is a possible but rare side effect of treatment with antidepressant medication in adults, but there is little known about its occurrence in children and adolescents. A newly published paper in JAMA Psychiatry investigated this, finding no evidence of mania/hypomania induced by antidepressants by 12 weeks after treatment initiation. However, caution is necessary in treatment for children with more severe depression or where a parent has bipolar disorder.

“In children and adolescents with unipolar depression, we did not find evidence of antidepressant-induced mania/hypomania by 12 weeks after treatment initiation”, says first author Suvi Virtanen, postdoctoral researcher at Karolinska Insitutet. “This corresponds to the timeframe for antidepressants to exert their psychotropic effect and when treatment-induced mania is expected to emerge. Hospitalisations, parental bipolar disorder, and the use of antipsychotics and antiepileptics were the most important predictors of mania/hypomania.”

Antidepressants are increasingly prescribed to paediatric patients with unipolar depression (as opposed to bipolar depression which is seldom diagnosed in childhood), but little is known about the risk of treatment-emergent mania (ie, the transition from depression into mania shortly after the initiation of antidepressant treatment). Previous research suggests paediatric patients may be particularly vulnerable to this adverse outcome. The results provide complementary information to randomised clinical trials (RCTs) from a large cohort of patients treated in a real-world setting.

The researchers conducted a register-based study on children and adolescents, aged 4–17, diagnosed with unipolar depression between 2006 and 2019. They applied the emulation of target trial framework to guide the study design and analysis, reducing the bias of observational studies and mimicking a RCT.

Antidepressant treatment was unrelated to the risk of mania/hypomania, suggesting other characteristics are more relevant when evaluating which patients may have an increased risk of switching from unipolar depression into mania. “Our model using administrative information from several national registers had a moderate predictive ability, suggesting it is possible to identify patients at high risk for mania/hypomania with a prognostic clinical prediction model. The model has potential to be improved in later work”, says senior author Zheng Chang, Principal Researcher at the Department of Medical Epidemiology and Biostatistics.

Source: Karolinska Institute

Categories : Paediatrics Pain ManagementTags :

Children’s ‘Growing Pains’ may be Tied to Migraines

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New research published in the journal Headache reveals that, in children and adolescents, pain in the lower limbs – what are often called “growing pains” by clinicians and are commonly attributed to rapid growth – may indicate the presence or risk of migraines.

The study included 100 children and adolescents born to mothers with migraines seen at a headache clinic, with half of the youth experiencing growing pains.

“In families of children with growing pains, there is an increased prevalence of other pain syndromes, especially migraine among parents,” the authors wrote. “On the other hand, children with migraine have a higher prevalence of growing pains, suggesting a common pathogenesis; therefore, we hypothesised that growing pains in children are a precursor or comorbidity with migraine.”

After five years of follow-up, 78 patients completed the study, of which 42 were from the group that experienced growing pains and 36 were from the control group. Headaches occurred in 76% of participants who had growing pains and in 22% of controls. Growing pains persisted in 14% of participants who had growing pains at the start of the study and appeared in 39% of participants who were previously asymptomatic.

“Pain in the lower limbs of children and adolescents… may reflect a precursor or comorbidity with migraine,” the authors concluded.

Source: Wiley

Categories : PaediatricsTags :

Listening Carefully to Parents of a Child with Gastroenteritis could Prevent After-hours Visits

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Acute gastroenteritis is a common infectious disease in children aged under 6 years. Although it often resolves on its own, it has a high consultation rate in primary care, especially during out-of-office hours. In a study published in The Annals of Family Medicine, Dutch researchers interviewed parents who contacted GPs outside of normal hours, and found that who felt misunderstood or ignored were more likely to request a visit.

The researchers conducted 14 semi-structured interviews with parents who contacted primary care physicians outside of normal operating hours seeking medical attention for their children. They sought to explore parental motivations, expectations, and experiences of off-hours primary care contacts for children with acute gastroenteritis. Parents were more likely to contact their primary care physician after hours when their child exhibited unusual behaviour, to prevent symptom deterioration, and to gain medical reassurances.

The researchers reported that parents expected their doctors to perform a thorough physical examination, provide information, and make follow-up care agreements. Parents reported dissatisfaction if they felt their doctors didn’t listen to them, misunderstood them, or didn’t take them seriously. This increased their likelihood of seeking another consultation. Researchers concluded that there is often a mismatch between parental expectations and GPs’ actions. Greater awareness and understanding on the part of GPs about the feelings and expectations of parents could guide them in interacting with parents, which may improve satisfaction with primary health care and reduce after-hours care requests.

The researchers found that among parents who requested out-of-office consultations for their children who were experiencing gastroenteritis, those that felt misunderstood or not listened to by their doctors were more likely to request such a visit. Taking greater account and understanding about parents’ feelings and expectations about care for their child may improve satisfaction with primary health care, specifically with requests that come in after normal clinic hours.

Source: EurekAlert!

Categories : Diseases, Syndromes and Conditions PaediatricsTags :

Strong Results from Methotrexate Trial for Severe Atopic Dermatitis in Kids

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Atopic dermatitis in a young patient. Source: NIH

Positive results from a clinical trial comparing the safety and efficacy of ciclosporin with methotrexate in children and adolescents with severe dermatitis will likely change treatment paradigms for this debilitating skin condition, its researchers have said. The trial, published in the British Journal of Dermatology, also examined whether the severity of the disease changed or returned after treatment ended.

For children and young people with atopic dermatitis, the most common skin condition in children, the main first line conventional systemic treatments are methotrexate and ciclosporin, two immuno-modulatory drugs.

There have been no adequately powered randomised clinical trial evidence for safety and treatment success for paediatric patients with this condition, and with new therapies being introduced at a high cost, establishing a gold standard for treatment with the conventional systemic therapies like methotrexate and ciclosporin is needed.

The trial, led by King’s College London, assessed 103 children with severe atopic dermatitis age 2–16 years across 13 centres in the UK and Ireland. The patients were given oral doses of methotrexate or ciclosporin and assessed over nine months of treatment and six months after the therapy ended.

The study found that ciclosporin works faster and reduces disease severity more at 12 weeks but was more expensive, whereas methotrexate was significantly cheaper and led to better objective disease control after 12 weeks and off therapy, with fewer participant-reported flares of atopic dermatitis after treatment had stopped. There were also no concerning safety signals.

Based on the TREAT trial findings, methotrexate is a useful and safe treatment in paediatric patients with severe atopic dermatitis and a good alternative to ciclosporin, especially in settings where health care resources are limited.

Professor Carsten Flohr, Chair in Dermatology and Population Health Sciences at King’s College London, and consultant dermatologist at St John’s institute of dermatology, Guy’s and St Thomas’ NHS Foundation Trust, said:

“This is the largest paediatric trial using conventional immuno-modulatory treatments in severe atopic dermatitis and was conducted across 13 centres in the UK and Ireland and is likely to change our treatment paradigm around this condition, not just for patients in the UK but also internationally.”

Source: King’s College London

Categories : Diet and Nutrition PaediatricsTags :

Activists Meet to Discuss Worsening Food Crisis for Children

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A group of activists for food access and affordability met yesterday (Thursday 21 September 2023) to discuss the worsening food crisis for children. Convened by the Nelson Mandela Children’s Fund and the DG Murray Trust, the meeting sought to identify urgent measures to combat rising rates of severe acute malnutrition and child hunger.

The activist group includes representatives of COSATU, the South African Council of Churches, civil
society groups and academics. It endorsed the proposal by the DG Murray Trust and the Grow Great Zero-Stunting Campaign for government and the food industry to contribute equally in making at least one product label of ten highly nutritious foods far more affordable to poorer households. This proposal requests food manufacturers and retailers to ‘double discount’ a list of ten best buy foods, with the amount of profit waived by industry matched by a retail subsidy by government.

“Data from the Department of Health shows that there were over 15 000 cases of severe acute malnutrition requiring hospitalisation in the 2022/3 financial year,” says Dr Linda Ncube Nkomo, CEO of the Nelson Mandela Children’s Fund. “But that is just the tip of the iceberg”, she says. “Malnutrition is the underlying cause of about one-third of all child deaths in South Africa today, this despite Section 28 of the Constitution which guarantees the right of nutrition to every child”.

The problem of acute malnutrition worsens the chronically high levels of food insecurity in South Africa,
with over a quarter of children under five nutritionally stunted. Poor physical growth is just one manifestation of much deeper damage being done to the life-long wellbeing of children, not least to their brain development,” says Dr Edzani Mphaphuli, Executive Director of the Grow Great zero-stunting campaign. “If we don’t stop stunting now,” Mphaphuli continues, “we shouldn’t expect learning outcomes to improve or our economy to grow.”

In addition to the double-discounted basket of ten best buys, the group called on the food formula industry to stop extracting massive profits from the poorest mothers, whose own malnutrition makes breastfeeding difficult. Given the high cost of infant formula, desperate mothers water down the milk to make it stretch further, which means that their babies don’t get enough protein and vitamins. It also called on government to ensure that every province has an effective programme in place to identify children at high risk and to provide nutritional supplementation to children failing to thrive.

The group undertook to monitor food prices actively and to challenge the food industry to make the third of young children who live below the food poverty line their responsibility too. “We are heartened that NEDLAC has tasked a multi-sectoral committee to review the viability of proposal to double-discount ten best buy foods”, says Dr David Harrison, CEO of the DG Murray Trust. “No sector of society – not government, not labour, not civil society nor industry – should be able to say that substantive proposals to feed South Africa’s children are too difficult, without putting a better option on the table.”

Categories : Paediatrics Skeletal SystemTags :

Newly Discovered Bone Stem Cell Drives Premature Skull Fusion

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Craniosynostosis, the premature fusion of the top of the skull in infants, is caused by an abnormal excess of a previously unknown type of bone-forming stem cell, according to a preclinical study published in Nature.

Occurring in one in 2500 babies, craniosynostosis arises from one of several possible gene mutations. By constricting brain growth, it can lead to abnormal brain development if not corrected surgically. In complex cases, multiple surgeries are needed.

Led by researchers at and led by researchers at Weill Cornell Medicine, the team focused on what happens in the skull of mice with one of the most common mutations found in human craniosynostosis. They found that the mutation drives premature skull fusion by inducing the abnormal proliferation of a type of bone-making stem cell, the DDR2+ stem cell, that had never been described before.

“We can now start to think about treating craniosynostosis not just with surgery but also by blocking this abnormal stem cell activity,” said study co-senior author Dr Matt Greenblatt, an associate professor of pathology and laboratory medicine at Weill Cornell Medicine and a pathologist at NewYork-Presbyterian/Weill Cornell Medical Center.

Histology image with stem cells labeled in red and skull region in green

A new stem cell driving disorders of premature skull fusion was transplanted (red), showing that it makes the cartilage seen at sites of skull fusion (green). Credit: Greenblatt lab.

In a study published in Nature in 2018, Dr Greenblatt, study co-senior author Dr Shawon Debnath and their colleagues, described the discovery of a type of bone-forming stem cell they called the CTSK+ stem cell. Because this type of cell is present in the top of the skull, or “calvarium,” in mice, they suspected that it has a role in causing craniosynostosis.

For the new study, they knocked out genes associated with craniosynostosis in CSTK+ stem cells in mice. They expected that the gene deletion somehow would induce these calvarial stem cells to go into bone-making overdrive. This new bone would fuse the flexible, fibrous material called sutures in the skull that normally allow it to expand in infants.

“We were surprised to find that, instead of the mutation in CTSK+ stem cells leading to these stem cells being activated to fuse the bony plates in the skull as we expected, mutations in the CTSK+ stem cells instead led to the depletion of these stem cells at the sutures – and the greater the depletion, the more complete the fusion of the sutures,” Dr Debnath said.

The unexpected finding led the team to hypothesise that another type of bone-forming stem cell was driving the abnormal suture fusion. After further experiments, and a detailed analysis of the cells present at fusing sutures, they identified the culprit: the DDR2+ stem cell, whose daughter cells make bone using a different process than that utilised by CTSK+ cells.

The team found that CTSK+ stem cells normally suppress the production of the DDR2+ stem cells. But the craniosynostosis gene mutation causes the CTSK+ stem cells to die off, allowing the DDR2+ cells to proliferate abnormally.

Collaborating with other researchers, they found the human versions of DDR2+ stem cells and CTSK+ stem cells in calvarial samples from craniosynostosis surgeries—underscoring the likely clinical relevance of their findings in mice.

The findings suggest that inappropriate DDR2+ stem cell proliferation in the calvarium, in infants with craniosynostosis-linked gene mutations, could be treated by suppressing this stem cell population, through mimicking the methods that CTSK+ stem cells normally use to prevent expansion of DDR2+stem cells. The researchers found that the CTSK+ stem cells achieve this suppression by secreting a growth factor protein called IGF-1, and possibly other regulatory proteins.

“We observed that we could partly prevent calvarial fusion by injecting IGF-1 over the calvarium,” said study first author Dr Seoyeon Bok, a postdoctoral researcher in the Greenblatt laboratory.

“I can imagine DDR2+ stem cell-suppressing drug treatments being used along with surgical management, essentially to limit the number of surgeries needed or enhance outcomes,” Dr. Greenblatt said.

In addition to treatment-oriented research, he and his colleagues now are looking for other bone-forming stem cell populations in the skull.

“This work has uncovered much more complexity in the skull than we ever imagined, and we suspect the complexity doesn’t end with these two stem cell types,” Dr Greenblatt said.

Source: Weill Cornell Medicine

Categories : Genetics PaediatricsTags :

Genetics can Make Paediatric Medicines Taste Sweeter

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Paediatric medicines often come in a sweetened liquid form for compliance in ingesting it, but if it’s too palatable, a child may empty an entire bottle and poison themselves. But children can perceive taste in different ways. A new study published in the International Journal of Molecular Sciences uncovers genetic variations in how sweetness of medicine is perceived, with adult participants of African descent finding it than those of European descent.

A multidisciplinary research group specialising in paediatrics, genetics, and psychophysics, co-led by Julie A. Mennella, PhD, Principal Investigator at the Monell Chemical Senses Center, has identified wide variation in the sensory perception of a paediatric formulation of ibuprofen. Some were tied to genetic ancestry, and some were not. These findings indicate that a range of factors come into play in determining how a medicine tastes to an individual. Their work is the first in a series of studies funded by the National Institutes of Health to look at variation in the taste of medicines.

“Taste is personal and determining how individuals differ and why is critical to understanding medication adherence and personal risks,” said Mennella. Bitter taste and irritating sensations in the throat are the top reasons for non-compliance, as a child (or adult) is less likely to ingest a medicine that is unpleasant (or tastes bad). However, if a child finds the medicine bottle uncapped and finds it tastes sweet like candy, they may ingest too much. Discovering how individuals differ in sensory perception is especially key when it comes to liquid ibuprofen, which accounts for many unintentional poison exposures among children younger than six years old in the US, according to the US Poison Centers.

“Sweetening medicines like ibuprofen is a delicate balance between having it taste good enough that kids take it, but bitter enough that, should they get unguarded access to it, it’s irritating enough that they stop drinking it and don’t poison themselves,” said Mennella. “We found genetic markers, both ancestry-related and independent of it, that could predict if someone would find a medication irritating or pleasantly sweet. If we get to the point of tailor-making medications in the future, knowing these associations could help us design taste specifically for each child in the not-so-distant future.”

The study included 154 adult panellists from Philadelphia, who represented the diversity of their city. According to a genome-wide association study, 63 had African ancestry, 51 European, 13 South Asian, seven East Asian, and seven American. They underwent training in sensory methods and then rated the sweetness, irritation, bitterness, and palatability of a paediatric formulation of a berry-flavoured ibuprofen after swallowing, and also after just tasting it without swallowing.

Researchers found that panellists of African genetic ancestry had fewer chemaesthetic sensations such as tingling or an urge to cough, rated the medicine as tasting sweeter and more palatable than those of European genetic ancestry. Researchers also found a novel association between the TRPA1rs1198875 genetic variation and tingling sensations, independent of ancestry. This is significant as TRPA1 is a family of neuron receptors that are involved in sensory neural response to a variety of chemical irritants found in foodstuff and other medicines.

Discovering both an ancestry-related link and non-ancestry-related genetic variation to taste and irritation perception shows that who perceives a medicine as palatable or not is a complicated picture and must consider a variety of factors.

This first study was conducted with adults because the sensory measures were complex and included several hour-long test sessions. That does not mean future tests should not include children, Mennella said, adding that this is just the first in a line of studies on the taste of paediatric medicines and methods need to be developed to measure sensory irritation in children. “This is a small study, but it is the first step in showing how research on diverse populations is needed to be able to unravel the genetic, cultural, dietary, and developmental paths that underlie medicine adherence and also risk for poisoning,” said Mennella. “It’s looking at both sides of the same, very important coin.”

Findings from this research will affect how sensory tests can be designed in the future. Since participants did both swallow and sip-and-spit tests, the team was able to determine that just tasting medicine allowed predictions and perceptions after swallowing, which could simplify future studies in different age groups. Other studies as part of this National Institutes of Health grant are ongoing, including determining the variation and acceptance of medicines in children.

Source: Monell Chemical Senses Center

Categories : Mental Health PaediatricsTags :

ADHD Medication Errors have Increased Nearly 300%

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In a new study published in Pediatrics, researchers investigated the characteristics and trends of out-of-hospital attention-deficit/hyperactivity disorder (ADHD) medication errors among children and teenagers reported to US poison centres from 2000 through 2021. Their results showed that the number of medication errors increased by nearly 300%, with over half resulting from an accidental double dosage.

ADHD is among the most common paediatric neurodevelopmental disorders. In 2019, nearly 10% of children in the US had a diagnosis of ADHD, roughly half of whom currently have a prescription for ADHD medication.

According to the study by at the Center for Injury Research and Policy and Central Ohio Poison Center at Nationwide Children’s Hospital, the annual number of ADHD-related medication errors increased 299% from 2000 to 2021. During the study period, there were 87 691 medication error cases involving ADHD medications as the primary substance among this age group reported to poison centres, yielding an average of 3985 individuals annually. In 2021 alone, 5235 medication errors were reported. The overall trend was driven by males, accounting for 76% of the medication errors and by the 6–12-year-old age group, accounting for 67% of the errors. Approximately 93% of exposures occurred in the home.

Among medication errors involving ADHD medications as the primary substance, the most common scenarios were:

  • 54% – “Inadvertently taken/given medication twice”
  • 13% – “Inadvertently taken/given someone else’s medication”
  • 13% – “Wrong medication taken/given”

“The increase in the reported number of medication errors is consistent with the findings of other studies reporting an increase in the diagnosis of ADHD among US children during the past two decades, which is likely associated with an increase in the use of ADHD medications,” said Natalie Rine, PharmD, co-author of the study and director of the Central Ohio Poison Center at Nationwide Children’s Hospital.

In 83% of cases, the individual did not receive treatment in a health care facility; however, 2.3% of cases resulted in admission to a health care facility, including 0.8% to a critical care unit. In addition, 4.2% of cases were associated with a serious medical outcome. Some children experienced agitation, tremors, seizures, and changes in mental status. Children under age 6 were twice as likely to experience a serious medical outcome and were more than three times as likely to be admitted to a health care facility than 6–19-year-olds.

“Because ADHD medication errors are preventable, more attention should be given to patient and caregiver education and development of improved child-resistant medication dispensing and tracking systems,” said Gary Smith, MD, DrPH, senior author of the study and director of the Center for Injury Research and Policy at Nationwide Children’s Hospital. “Another strategy may be a transition from pill bottles to unit-dose packaging, like blister packs, which may aid in remembering whether a medication has already been taken or given.”

Although prevention efforts should focus on the home setting additional attention should be given to schools and other settings where children and adolescents spend time and receive medication.

Source: Nationwide Children’s Hospital