February 12, 2020
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Kids often exposed to pills removed from childproof containers

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More than half of unsupervised prescription medication exposures among children occur after the pills are removed from childproof packaging, recently published study findings suggest.

Data from U.S. poison control centers also showed that kids are frequently exposed to unpackaged over-the-counter products.

“These data suggest it may be time to place greater emphasis on encouraging adults to keep medicines in containers with child-resistant features,” Daniel Budnitz, MD, MPH, director of the CDC’s Medication Safety Program, said in a statement. “There is an opportunity here for innovative medication container options that promote adult adherence and provide portability and convenience, while maintaining child safety.”

Budnitz and colleagues enrolled around 4,500 callers to five poison control centers in Arizona, Florida and Georgia between February and September 2017 and asked them about the circumstances of pediatric unsupervised medication exposures. According to the responses, 61% of exposures involved medications that were accessed from the original container or packaging.

 
Data from U.S. poison control centers showed that more than 50% of kids poisoned by prescription pills got them after an adult removed the safety packaging. 
Source: Shutterstock.com

Of the exposures to unprotected medication, 71.6% involved children aged younger than 2 years, and around 30% of the exposures to prescription pills involved grandparents’ medications.

The researchers identified common reasons that adults reported transferring medication to other containers, including to remember to take it (36.5% of parents and 56.3% of grandparents) and to make it easier for traveling (34.3% of parents and 10.8% of grandparents). Medication that was not in a container had been dropped or accidentally left out in 38% of cases or had been removed because someone was getting ready to take it (34.3%).

Budnitz and colleagues also found that:

  • 51.5% of exposures to prescription medications involved children accessing medications that had previously been removed from the original packaging, and 20.8% involved OTC products;
  • 33.8% of exposures involved only prescription medications, 32.8% involved only OTC products that required child-resistant packaging, and 29.9% involved one OTC product that did not require child-resistant packaging;
  • ADHD medications (49.3%) and opioids (42.6%) were often not in any container when accessed; anticonvulsants (41.1%), hypoglycemic agents (33.8%), and cardiovascular/antithrombotic agents (30.8%) often were transferred to alternate containers;
  • grandparents’ medications were involved in 7.8% of OTC product exposures.

“Recent progress in reducing pediatric medication exposures coincided with innovations in packaging designed to limit access by children ... and education targeted to parents,” Budnitz and colleagues wrote. “Further reductions in pediatric exposures will require efforts to prevent solid dose medication exposures in which adults, rather than children, remove medications from child-resistant packaging.”

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One way this can be done, they said, is by designing packages that “limit adult circumvention of child-resistant packaging.”

“Educational messages to keep medications up and away and out of sight of young children should target grandparents, as well as parents of young children, and include messages on improving safety if adults use alternate containers,” they wrote. – by Gerard Gallagher

Disclosures: The authors report no relevant financial disclosures.