Methodological Challenges in Describing Medication Dosing Errors in Children

Abstract

Although children are prescribed medications in 30 percent to 50 percent of clinic visits, little is known about medication errors in ambulatory pediatrics. In the process of completing a study to determine the prevalence of outpatient dosing errors, we identified a number of barriers to understanding the epidemiology of medication errors in children. These barriers include prescribing medication that is not labeled for use in children, discrepancies in published dosing recommendations for many medications, unclear guidelines on use of adult dosing recommendations for children of different ages and weights, and the lack of readily available documented weights to determine appropriate weight-based doses for children. In our study of pediatric medication errors, we found a wide range of doses prescribed to children for every medication we studies. Before we can truly understand medication errors in children and begin developing systems-based approaches to eliminating these errors, we need better national standards of medication doses that are appropriate for children and an improved ability to determine errors through databases that include children's weights as well as prescription information.