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‘Preventable’ ADHD Medication Errors Have Shot Up by 300%: Report

Medical errors related to giving children with attention deficit hyperactivity disorder (ADHD) their medication have skyrocketed, rising by a whopping 299% over the last two decades, according to a new study in the journal Pediatrics.

For the study, researchers from the Center for Injury Research and Policy and Central Ohio Poison Center at Nationwide Children’s Hospital examined two decades of data from poison centers across the United States to identify any trends related to ADHD medication errors, such as taking the incorrect medicine or the wrong dosage. They discovered that not only did these mistakes rise steadily during the last 20 years, they have become even more frequent in recent years.

In 2021 alone, there were more than 5,000 reported errors related to ADHD medications, affecting one child every 100 minutes.

The researchers observed a total of 87,691 ADHD medication errors in individuals younger than 20 years old during the study’s timeframe. Of these errors, 67% occurred in children aged between 6 and 12, and 76% of the reports were on males.

“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 U.S. children during the past two decades, which is likely associated with an increase in the use of ADHD medications,” study co-author Natalie Rine, PharmD, director of the Central Ohio Poison Center at Nationwide Children’s Hospital, said in a release on the findings.

ADHD is a neurodevelopmental disorder that affects millions of children in the U.S. It often manifests in kids in the form of inattention, hyperactivity and impulsivity. 

Treatment for ADHD can vary based on a number of factors, but it often includes the use of medications that are taken daily for the management of its related symptoms. The Centers for Disease Control and Prevention (CDC) estimates that as many as 81% of children aged 3 to 17 years who have ADHD follow a medication regimen.

Stimulant medications, like Adderall and Ritalin, are commonly used in children who have ADHD to help ease the burden of their symptoms. Non-stimulant medications in the form of selective norepinephrine reuptake inhibitors, like Strattera, and alpha-adrenergic agonists, like Kapvay, are also used to regulate ADHD symptoms. Several of these drugs have been facing an ongoing shortage, with no reported end in sight.

Each of these medications are considered safe to use in children under the care of an adult, but they do come with potentially harmful side effects, especially when taken incorrectly.

Concerningly, 54% of the errors reported involved a child taking or being given their medication twice, resulting in them receiving double their regular dosage. Although the majority of these mistakes did not warrant medical treatment, around 2% of them resulted in hospital admission. Of those, 4% led to a serious medical outcome, like seizures and altered mental status.

Children under the age of six were three times more likely to experience an adverse outcome or to be hospitalized due to the errors.

Gary Smith, M.D., director of the Center for Injury Research and Policy at Nationwide Children’s Hospital, said that the increase in errors could be owed, at least in part, to how these medications are tracked and distributed.

“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,” Dr. Smith said. 

Another way to decrease the frequency of medication errors centers on how the medicines are packaged. Dr. Smith suggests that ADHD medications could be packaged in individual units, or “blister packs” instead of in pill bottles to make it easier to remember if a dose has been taken. Blister packs are common to medications like birth control and steroid packs.

And then there is the matter of outside caregiver education. The majority — 93% — of the medication errors reported during the study period occurred in a home setting, but parents are not the only ones helping children with medication. 

Children could take their meds at friends’ or family members’ houses if they are away from home, and these medicines are often given during school hours by teachers or nurses as well. The researchers suggest that prevention efforts should also include these areas.

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